DR. EDDY E BERGES, M.D. - NPI NUMBER 1295757615

Summary

Provider Name: DR. EDDY E BERGES, M.D.

NPI Number: 1295757615

Clasification: Specialist (174400000X)

Address:
2706 W SAINT ISABEL ST
SUITE A
TAMPA, FL
ZIP 33607

Phone Number: (813) 870-3665



Detailed Information

DR. Eddy E Berges, M.D. is a specialist in Tampa, FL with 40 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. The assigned NPI number for this provider is 1295757615 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

2706 W SAINT ISABEL ST
SUITE A
TAMPA, FL
ZIP 33607-382
Phone: (813) 870-3665
Fax: (813) 870-3668

The enumeration date for this NPI number is 7/24/2006 and was last updated on 7/8/2007.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 174400000X Specialist ME34935 FL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 30543 MEDICARE ID-TYPE UNSPECIFIED FL
2 D54030 MEDICARE UPIN FL

NPI Record

No. Field Name Field Value
1 NPI 1295757615
2 Entity Type Code 1
3 Provider Last Name Legal Name BERGES
4 Provider First Name EDDY
5 Provider Middle Name E
6 Provider Name Prefix Text DR.
7 Provider Credential Text M.D.
8 Provider First Line Business Practice Location Address 2706 W SAINT ISABEL ST
9 Provider Second Line Business Practice Location Address SUITE A
10 Provider Business Practice Location Address City Name TAMPA
11 Provider Business Practice Location Address State Name FL
12 Provider Business Practice Location Address Postal Code 336076382
13 Provider Business Practice Location Address Country Code If outside U S US
14 Provider Business Practice Location Address Telephone Number 8138703665
15 Provider Business Practice Location Address Fax Number 8138703668
16 Provider Enumeration Date 7/24/2006
17 Last Update Date 7/8/2007
18 Provider Gender Code M
19 Healthcare Provider Taxonomy Code 1 174400000X
20 Provider License Number 1 ME34935
21 Provider License Number State Code 1 FL
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 30543
24 Other Provider Identifier Type Code 1 04
25 Other Provider Identifier State 1 FL
26 Other Provider Identifier 2 D54030
27 Other Provider Identifier Type Code 2 02
28 Other Provider Identifier State 2 FL
29 Is Sole Proprietor Y

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This page was last updated on: 11/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.