Provider Demographics
NPI:1629396056
Name:LEWIS H. BERGER MD PA
Entity Type:Organization
Organization Name:LEWIS H. BERGER MD PA
Other - Org Name:COSMETIC & RECONSTRUCTIVE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-877-7658
Mailing Address - Street 1:2901 W SAINT ISABEL ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6371
Mailing Address - Country:US
Mailing Address - Phone:813-877-7658
Mailing Address - Fax:813-872-8305
Practice Address - Street 1:2901 W SAINT ISABEL ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6371
Practice Address - Country:US
Practice Address - Phone:813-877-7658
Practice Address - Fax:813-872-8305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty