Individual
THERESA MARIE BERGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1507 S HIAWASSEE RD, STE 107, ORLANDO, FL 32835-5706
(407) 445-9545
(407) 299-9141
Mailing address
1507 S HIAWASSEE RD, STE 107, ORLANDO, FL 32835-5706
(407) 445-9545
(407) 299-9141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9104797
FL
363AM0700X
Medical Physician Assistant
Primary
PA9104797
FL
Other
Enumeration date
11/03/2008
Last updated
10/01/2020
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