Provider Demographics
NPI:1902832355
Name:RICHARD D BERKOWITZ MD PA
Entity Type:Organization
Organization Name:RICHARD D BERKOWITZ MD PA
Other - Org Name:UNIVERSITY ORTHOPEDIC AND JOINT REPLACEMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BERKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-718-7776
Mailing Address - Street 1:7171 N UNIVERSITY DR
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2902
Mailing Address - Country:US
Mailing Address - Phone:954-718-7776
Mailing Address - Fax:954-597-7773
Practice Address - Street 1:7171 N UNIVERSITY DR
Practice Address - Street 2:SUITE # 100
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2902
Practice Address - Country:US
Practice Address - Phone:954-718-7776
Practice Address - Fax:954-597-7773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71454207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL251002OtherAVMED PROVIDER NUMBER
FL9034OtherNEIGHBORHOOD HEALTH
FL32382OtherBCBS OF FLORIDA
FL2507820OtherAETNA HMO NUMBER
FL0598628OtherGHI ID #
FL4590850001Medicare NSC
FL2507820OtherAETNA HMO NUMBER
FL251002OtherAVMED PROVIDER NUMBER