Individual
DALE BERGAMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4742
(813) 259-8803
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME97143
FL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
ME97143
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276902600
—
FL
01
—
68337
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/27/2006
Last updated
05/18/2011
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