Individual
DR. LAWRENCE BRUCE BERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 N US HIGHWAY 441 STE 540, LADY LAKE, FL 32159-8987
(352) 753-9777
(866) 446-1888
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME64597
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23146
BLUE CROSS BLUE SHIELD
FL
05
—
275622600
—
FL
Enumeration date
08/09/2005
Last updated
07/19/2023
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