Individual
DR. LESLIE ROBERT BERGHASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
207YS0123X
Facial Plastic Surgery Physician
Primary
ME0052176
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
255062800
—
FL
Enumeration date
10/12/2006
Last updated
09/23/2008
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