Individual
DR. GARY LEE BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 HARBOR BLVD, SUITE 21, PORT CHARLOTTE, FL 33952-5052
(941) 625-6992
(941) 625-7238
Mailing address
2234 COLONIAL BLVD, MANAGED CARE DEPARTMENT, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0030516
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002736800
—
FL
01
—
1192904
WELLCARE
FL
01
—
217124
AVMED
FL
01
—
25028
BCBS PROVIDER #
FL
01
—
47450
BCBS OF FL
FL
01
—
8707000
CIGNA PROVIDER #
FL
Enumeration date
11/18/2005
Last updated
04/25/2016
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