Individual
STUART BERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 LONGWOOD AVE, ROCKLEDGE, FL 32955-2828
(800) 476-8646
(919) 382-3210
Mailing address
PO BOX 30731, TAMPA, FL 33630-3731
(800) 476-8646
(919) 382-3210
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME51149
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048212900
—
FL
01
—
05983
GROUP # 34457
FL
Enumeration date
05/31/2005
Last updated
07/21/2008
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