Organization
DRS BERGHASH & LANZA PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH HARRIS (PRACTICE ADMINISTRATOR)
(772) 979-4035
Entity
Organization
Contact information
Practice address
1801 SE HILLMOOR DR, SUITE B105, PORT ST LUCIE, FL 34952-7545
(772) 398-9911
(772) 398-4374
Mailing address
1801 SE HILLMOOR DR, SUITE B105, PORT ST LUCIE, FL 34952-7545
(772) 398-9911
(772) 398-4374
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH6061
RR MEDICARE
FL
Enumeration date
04/28/2006
Last updated
12/29/2014
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