Provider Demographics
NPI:1629011887
Name:BERMAN, MIKHAIL N (MD)
Entity Type:Individual
Prefix:DR
First Name:MIKHAIL
Middle Name:N
Last Name:BERMAN
Suffix:
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 1:8295 NORTH MILITARY TRAIL
Mailing Address - Street 2:SUITE G
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-626-3205
Mailing Address - Fax:888-959-2478
Practice Address - Street 1:8295 NORTH MILITARY TRAIL
Practice Address - Street 2:SUITE G
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-626-3205
Practice Address - Fax:888-959-2478
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0045620207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL044198800Medicaid
FL96875Medicare ID - Type UnspecifiedMEDICARE