Provider Demographics
NPI:1700276482
Name:RENATO BERGER, MD, PA
Entity Type:Organization
Organization Name:RENATO BERGER, MD, PA
Other - Org Name:REANTO BERGER, MD, PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-794-1360
Mailing Address - Street 1:5300 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4395
Mailing Address - Country:US
Mailing Address - Phone:954-794-1360
Mailing Address - Fax:954-794-1367
Practice Address - Street 1:5300 W HILLSBORO BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4395
Practice Address - Country:US
Practice Address - Phone:954-794-1360
Practice Address - Fax:954-794-1367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty