Provider Demographics
NPI:1649233859
Name:BERMAN, ROBERT L (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:BERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS3686207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82089ZMedicare PIN
FLD65844Medicare UPIN