Provider Demographics
NPI:1588186217
Name:BERSSON, BEN ELLIOT
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:ELLIOT
Last Name:BERSSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 SE 7TH AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-5339
Mailing Address - Country:US
Mailing Address - Phone:305-987-0441
Mailing Address - Fax:
Practice Address - Street 1:440 SAWGRASS CORPORATE PKWY STE 106
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33325-6236
Practice Address - Country:US
Practice Address - Phone:954-745-1112
Practice Address - Fax:954-745-1120
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2019-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral