Provider Demographics
NPI:1972574408
Name:BERGER, ADAM SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:SCOTT
Last Name:BERGER
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 1:250 AVENUE K SW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33880-3919
Mailing Address - Country:US
Mailing Address - Phone:863-297-5400
Mailing Address - Fax:860-293-9780
Practice Address - Street 1:250 AVENUE K SW
Practice Address - Street 2:SUITE 200
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33880-3919
Practice Address - Country:US
Practice Address - Phone:863-297-5400
Practice Address - Fax:860-293-9780
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76336207W00000X
FLME0076336207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256885300Medicaid
FLE1411Medicare PIN
FL256885300Medicaid