Provider Demographics
NPI:1861533804
Name:BERMAN, RICHARD A (OD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:BERMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:4112 OXBOW DR
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-5116
Mailing Address - Country:US
Mailing Address - Phone:954-675-7447
Mailing Address - Fax:
Practice Address - Street 1:4635 N UNIVERSITY DR
Practice Address - Street 2:C/O FOR EYES OPTICAL
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4602
Practice Address - Country:US
Practice Address - Phone:954-905-3474
Practice Address - Fax:954-227-2898
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3211152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist