Individual
AGNES Z SUPALA BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3848 FAU BLVD STE 305, BOCA RATON, FL 33431-6437
(305) 243-3100
(305) 243-8108
Mailing address
210 BRUNSWICK AVE, TORONTO, ONTARIO M5S 2-M5
(416) 922-7902
(416) 922-7902
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME157410
FL
2084N0600X
Clinical Neurophysiology Physician
ME157410
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238333
LICENSE
NY
Enumeration date
02/06/2007
Last updated
12/21/2022
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