Provider Demographics
NPI:1093963787
Name:TOBY BERMAN PSY D PA
Entity Type:Organization
Organization Name:TOBY BERMAN PSY D PA
Other - Org Name:TOBY BERMAN PSY D
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:305-785-5964
Mailing Address - Street 1:4302 ALTON RD
Mailing Address - Street 2:STE 960 MSOP
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2891
Mailing Address - Country:US
Mailing Address - Phone:305-673-0797
Mailing Address - Fax:305-531-8982
Practice Address - Street 1:4302 ALTON RD STE 960
Practice Address - Street 2:MOUNT SINAI MEDICAL CENTER
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2890
Practice Address - Country:US
Practice Address - Phone:305-673-0797
Practice Address - Fax:305-531-8982
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOBY BERMAN PSY D PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-05
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003338103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBH546Medicare PIN