Provider Demographics
NPI:1720045933
Name:BERKES, EVA A
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:A
Last Name:BERKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2088 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2307
Mailing Address - Country:US
Mailing Address - Phone:941-953-5050
Mailing Address - Fax:941-343-8021
Practice Address - Street 1:2068 HAWTHORNE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2307
Practice Address - Country:US
Practice Address - Phone:941-953-5050
Practice Address - Fax:941-343-8021
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77461207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL28001OtherBC/BS FLORIDA
FL202478375OtherTAX ID
FLP00398291OtherRAILROAD MEDICARE
FL202478375OtherTAX ID
FLH67125Medicare UPIN