Individual
AJAY BERRY ANTONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 NEWBERRY RD, GAINESVILLE, FL 32607-2245
(352) 336-6000
Mailing address
4500 NEWBERRY RD, GAINESVILLE, FL 32607-2245
(352) 336-6000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME125276
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME125276
FL
207R00000X
Internal Medicine Physician
TRN16049
FL
208VP0000X
Pain Medicine Physician
ME125276
FL
208VP0014X
Interventional Pain Medicine Physician
Primary
ME125276
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017383300
—
FL
Enumeration date
05/10/2011
Last updated
04/27/2022
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