Basic Information
| Provider Information | |||||||||
| NPI: | 1639367642 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BERC SARAFIAN P A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2810 W SAINT ISABEL ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336076375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138908004 | ||||||||
| FaxNumber: | 7275180762 | ||||||||
| Practice Location | |||||||||
| Address1: | 1920 W BAY DR | ||||||||
| Address2: | SUITE 6 | ||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337703022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275841344 | ||||||||
| FaxNumber: | 7275847855 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2007 | ||||||||
| LastUpdateDate: | 08/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | SARAFIAN | ||||||||
| AuthorizedOfficialFirstName: | BERC | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8138908004 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225500000X | ME46578 | FL | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist |
No ID Information.