Provider Demographics
NPI:1740275528
Name:BERMAN, JULIAN (MD)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:BERMAN
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 1:9800 W SAMPLE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-344-8700
Mailing Address - Fax:954-755-8138
Practice Address - Street 1:9800 W SAMPLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-344-8700
Practice Address - Fax:954-755-8138
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0034303207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006383300Medicaid
FL93778TMedicare PIN
B72995Medicare UPIN
FL93778RMedicare PIN
FL93778VMedicare PIN
FL93778Medicare PIN
FL006383300Medicaid