Provider Demographics
NPI:1417236225
Name:BEREZ, BURTON (CRT)
Entity Type:Individual
Prefix:
First Name:BURTON
Middle Name:
Last Name:BEREZ
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 LUNA WAY
Mailing Address - Street 2:#155
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-0171
Mailing Address - Country:US
Mailing Address - Phone:702-438-2729
Mailing Address - Fax:702-795-2729
Practice Address - Street 1:1120 N TOWN CENTER DR
Practice Address - Street 2:#120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-6301
Practice Address - Country:US
Practice Address - Phone:818-935-3727
Practice Address - Fax:866-960-7692
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRC 1189227800000X
FLTT 3919227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified