Berg, Amanda Lisa
Berg, Amanda Lisa is an individual health care provider with primary practice located at 21097 Ne 27Th Ct Suite 490, Aventura FL 33180-1204. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Berg, Amanda Lisa can be contacted via phone (305) 466-0663.Contact Information
Primary practice address
21097 Ne 27Th Ct Suite 490
Aventura FL 33180-1204
Phone: (305) 466-0663
Fax: (305) 466-9537
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME101078 | Florida |
Profile Details
NPI number | 1699984062 |
---|---|
LBN Legal business name | Berg, Amanda Lisa |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 22nd, 2007 |
Last updated | Feb 12th, 2016 - about 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1699984062 | NPPES |
Florida | MEDICAID | 000492100 |
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