Individual
DR. BLAKE M BERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 W PLYMOUTH AVE, DELAND, FL 32720-3236
(386) 943-3160
(317) 705-5047
Mailing address
4914 PACIFICO CT, PALM BEACH GARDENS, FL 33418-8994
(248) 310-3603
(561) 622-6399
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
4301052661
MI
2085R0202X
Diagnostic Radiology Physician
4301052661
MI
2085R0202X
Diagnostic Radiology Physician
Primary
ME97498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3056378
—
MI
05
—
3056387
—
MI
Enumeration date
07/04/2006
Last updated
02/16/2024
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