Provider Demographics
NPI:1144655374
Name:RICHARD ARNOLD BERGER MD CORP
Entity type:Organization
Organization Name:RICHARD ARNOLD BERGER MD CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-674-2609
Mailing Address - Street 1:4300 ALTON RD
Mailing Address - Street 2:SUITE 2070
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2948
Mailing Address - Country:US
Mailing Address - Phone:305-674-2609
Mailing Address - Fax:305-674-2693
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:SUITE 2070
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2948
Practice Address - Country:US
Practice Address - Phone:305-674-2609
Practice Address - Fax:305-674-2693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME12219207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME12219OtherLICENSE NUMBER
FLME12219OtherLICENSE NUMBER
13890UMedicare PIN