Berens, Keith A

Berens, Keith A is an individual health care provider with primary practice located at 1717 North E Street Suite 422, Pensacola FL 32501-6339. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Berens, Keith A can be contacted via phone (850) 444-7050.

Contact Information

Primary practice address
1717 North E Street Suite 422 Pensacola FL 32501-6339
Phone: (850) 444-7050
Fax: (850) 434-8879
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9101561 Florida

Profile Details

NPI number 1174505788
LBN Legal business name Berens, Keith A
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174505788 NPPES
Florida MEDICAID 291015200
Florida Other 59039584

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