Supala Berger, Agnes Z
Supala Berger, Agnes Z is an individual health care provider with primary practice located at 3848 Fau Blvd Ste 305 , Boca Raton FL 33431-6437. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Neurophysiology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is her primary health care specialty. Supala Berger, Agnes Z can be contacted via phone (305) 243-3100.Contact Information
Primary practice address
3848 Fau Blvd Ste 305
Boca Raton FL 33431-6437
Phone: (305) 243-3100
Fax: (305) 243-8108
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | ME157410 | Florida |
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | ME157410 | Florida |
Profile Details
| NPI number | 1245379932 |
|---|---|
| LBN Legal business name | Supala Berger, Agnes Z |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Dec 21st, 2022 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245379932 | NPPES |
| New York | Other | 238333 | LICENSE |
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