Provider Demographics
NPI:1942326830
Name:ROBERT L BERMAN DO PA
Entity Type:Organization
Organization Name:ROBERT L BERMAN DO PA
Other - Org Name:BROWARD FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-484-1710
Mailing Address - Street 1:7225 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2908
Mailing Address - Country:US
Mailing Address - Phone:954-484-1710
Mailing Address - Fax:954-484-7882
Practice Address - Street 1:7225 N UNIVERSITY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2908
Practice Address - Country:US
Practice Address - Phone:954-484-1710
Practice Address - Fax:954-484-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC267Medicare PIN
D65844Medicare UPIN