Provider Demographics
NPI:1437492527
Name:RICHARD A. BERMAN, O.D., P.A.
Entity Type:Organization
Organization Name:RICHARD A. BERMAN, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-557-9004
Mailing Address - Street 1:4635 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4602
Mailing Address - Country:US
Mailing Address - Phone:305-557-9004
Mailing Address - Fax:866-295-9120
Practice Address - Street 1:4635 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4602
Practice Address - Country:US
Practice Address - Phone:305-557-9004
Practice Address - Fax:866-295-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3211152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620565800Medicaid
FLU77994Medicare UPIN