Provider Demographics
NPI:1265427405
Name:BERLAND, GREGORY A (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:BERLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2410 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2236
Mailing Address - Country:US
Mailing Address - Phone:727-771-1300
Mailing Address - Fax:727-781-3312
Practice Address - Street 1:11663 COUNTRYWAY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2739
Practice Address - Country:US
Practice Address - Phone:813-891-6310
Practice Address - Fax:813-891-6889
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME83697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4441393OtherCIGNA
FL1048101OtherCAREPLUS
FL04896OtherUNIVERSAL
FL289697OtherAVMED
FL15336OtherBCBS INDIVIDUAL
FL267002000Medicaid
FL7230565OtherAETNA
FL4441393OtherCIGNA
FL1048101OtherCAREPLUS