Individual
MICHAEL BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
811 N SUMMIT ST, CRESCENT CITY, FL 32112-2191
(386) 698-2101
Mailing address
PO BOX 2400, MELBOURNE, FL 32902-2400
(321) 837-3820
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0002470
FL
363AM0700X
Medical Physician Assistant
Primary
PA2470
FL
Other
Enumeration date
10/05/2005
Last updated
02/23/2026
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