Provider Demographics
NPI:1588649586
Name:BERTRAM, HERBERT MORTON III (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:MORTON
Last Name:BERTRAM
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8569
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-8569
Mailing Address - Country:US
Mailing Address - Phone:239-624-0400
Mailing Address - Fax:239-624-0464
Practice Address - Street 1:311 9TH ST N STE 101
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5886
Practice Address - Country:US
Practice Address - Phone:239-624-1700
Practice Address - Fax:239-624-1751
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35059268207X00000X
FLME78271207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102605200Medicaid
FL49133OtherBCBS
49133OtherBCBS
49133Medicare PIN