Berghash, Leslie Robert

Berghash, Leslie Robert is an sole proprietor health care provider with primary practice located at 1801 Se Hillmoor Dr Suite B105, Port St Lucie FL 34952-7545. He recently has only one registered license in Allopathic & Osteopathic Physicians / Facial Plastic Surgery, which is considered as his primary health care specialty. Berghash, Leslie Robert can be contacted via phone (772) 398-9911.

Contact Information

Primary practice address
1801 Se Hillmoor Dr Suite B105 Port St Lucie FL 34952-7545
Phone: (772) 398-9911
Fax: (772) 398-4374
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X ME0052176 Florida

Profile Details

NPI number 1255420485
LBN Legal business name Berghash, Leslie Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated Sep 23rd, 2008 - about 17 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 1255420485 NPPES
Florida MEDICAID 255062800

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