Individual
BRIAN BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1210 CROSSFIELD DR, APOPKA, FL 32703-1540
(407) 921-3968
Mailing address
1210 CROSSFIELD DR, APOPKA, FL 32703-1540
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
EMT 539865
FL
2255A2300X
Athletic Trainer
Primary
1874
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E3033546
NREMT
FL
Enumeration date
07/06/2014
Last updated
07/29/2016
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