Provider Demographics
NPI:1942799424
Name:BERMAN PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:BERMAN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-564-0069
Mailing Address - Street 1:501 GOODLETTE RD N STE C100
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5665
Mailing Address - Country:US
Mailing Address - Phone:239-564-0069
Mailing Address - Fax:
Practice Address - Street 1:501 GOODLETTE RD N STE C100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5665
Practice Address - Country:US
Practice Address - Phone:239-564-0069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy