Provider Demographics
NPI:1225249568
Name:BERRYMAN, KATHRYN E (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:E
Last Name:BERRYMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2415 N ORANGE AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-5505
Mailing Address - Country:US
Mailing Address - Phone:407-622-0560
Mailing Address - Fax:407-622-0563
Practice Address - Street 1:2415 N ORANGE AVE STE 402
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-5505
Practice Address - Country:US
Practice Address - Phone:407-622-0560
Practice Address - Fax:407-622-0563
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138628207VM0101X, 207V00000X, 2083B0002X
MO2018008440207VM0101X
TXR4943207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine