Provider Demographics
NPI:1144329780
Name:BERKOWITZ, BRUCE M (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:M
Last Name:BERKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 SOUTH PINE ISLAND ROAD
Mailing Address - Street 2:STE 300
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3178
Mailing Address - Country:US
Mailing Address - Phone:954-473-6344
Mailing Address - Fax:954-476-9077
Practice Address - Street 1:600 SOUTH PINE ISLAND ROAD
Practice Address - Street 2:STE 300
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3178
Practice Address - Country:US
Practice Address - Phone:954-473-6344
Practice Address - Fax:954-476-9077
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37474174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD65251Medicare UPIN