Berg, Susan L.

Berg, Susan L. is an individual health care provider with primary practice located at 3503 E Frontage Rd , Tampa FL 33607-1742. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Berg, Susan L. can be contacted via phone (813) 586-8187.

Contact Information

Primary practice address
3503 E Frontage Rd Tampa FL 33607-1742
Phone: (813) 586-8187
Fax: (813) 321-6998
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 150718 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 150718 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN9432283 Florida

Profile Details

NPI number 1639210412
LBN Legal business name Berg, Susan L.
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 12th, 2007
Last updated Aug 3rd, 2023 - about 2 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 1639210412 NPPES
Missouri MEDICAID 428420509
Missouri Other 159889758

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