Berry, Jerisa
Berry, Jerisa is an individual health care provider with primary practice located at 11903 Southern Blvd Ste 108 , Royal Palm Beach FL 33411-7644. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Berry, Jerisa can be contacted via phone (561) 793-1475.Contact Information
Primary practice address
11903 Southern Blvd Ste 108
Royal Palm Beach FL 33411-7644
Phone: (561) 793-1475
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 125049751 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 125049751 | Illinois |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | OS12892 | Florida |
Profile Details
| NPI number | 1679760045 |
|---|---|
| LBN Legal business name | Berry, Jerisa |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 1st, 2007 |
| Last updated | Feb 27th, 2020 - about 4 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 | 1679760045 | NPPES |
| Illinois | MEDICAID | 036119674 |
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