Provider Demographics
NPI:1760508204
Name:BERMAN, JOANTHAN ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOANTHAN
Middle Name:ALAN
Last Name:BERMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 CLARK RD
Mailing Address - Street 2:SUITE H-1
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-2301
Mailing Address - Country:US
Mailing Address - Phone:941-926-1600
Mailing Address - Fax:941-926-1166
Practice Address - Street 1:3900 CLARK RD
Practice Address - Street 2:SUITE H-1
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2301
Practice Address - Country:US
Practice Address - Phone:941-926-1600
Practice Address - Fax:941-926-1166
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8486111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88166OtherBLUE CROSS BLUE SHIELD #
FL8486OtherCHIRO LIC #