Provider Demographics
NPI:1043324429
Name:BERKOWER, DAVID LOUIS (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LOUIS
Last Name:BERKOWER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SW 129TH AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1761
Mailing Address - Country:US
Mailing Address - Phone:954-430-9972
Mailing Address - Fax:954-430-9902
Practice Address - Street 1:1 SW 129TH AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1761
Practice Address - Country:US
Practice Address - Phone:954-430-9972
Practice Address - Fax:954-430-9902
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8977208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI19536Medicare UPIN
FL48435Medicare ID - Type Unspecified