Provider Demographics
NPI:1669534012
Name:BERKES, BEATRICE JENNIFER (MD)
Entity type:Individual
Prefix:
First Name:BEATRICE
Middle Name:JENNIFER
Last Name:BERKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 MANATEE AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8663
Mailing Address - Country:US
Mailing Address - Phone:941-748-4747
Mailing Address - Fax:941-748-4448
Practice Address - Street 1:702 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8663
Practice Address - Country:US
Practice Address - Phone:941-748-4747
Practice Address - Fax:941-748-4448
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89724207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H87240Medicare UPIN
01013AMedicare ID - Type Unspecified