Provider Demographics
NPI:1891741708
Name:SARAFIAN, BERC (MD)
Entity Type:Individual
Prefix:DR
First Name:BERC
Middle Name:
Last Name:SARAFIAN
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 1:2810 W SAINT ISABEL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6375
Mailing Address - Country:US
Mailing Address - Phone:813-890-8004
Mailing Address - Fax:727-518-0762
Practice Address - Street 1:1518 S MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2237
Practice Address - Country:US
Practice Address - Phone:727-584-1344
Practice Address - Fax:727-584-7855
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046578207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255839400Medicaid
FLB48141Medicare UPIN
FL4499420001Medicare NSC
FL255839400Medicaid