| Bercaw Neuropsychology | |
|
710 Oakfield Dr Ste 153 Brandon FL 33511-4954 | |
| (813) 603-7635 | |
| (813) 501-1186 |
| Full Name | Bercaw Neuropsychology |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 710 Oakfield Dr Ste 153, Brandon, Florida |
| Authorized Official Name and Position | Edwin Bercaw (NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 8136037635 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bercaw Neuropsychology 710 Oakfield Dr Ste 153 Brandon FL 33511-4954 Ph: (813) 603-7635 | Bercaw Neuropsychology 710 Oakfield Dr Ste 153 Brandon FL 33511-4954 Ph: (813) 603-7635 |
| NPI Number | 1134633092 |
|---|---|
| Provider Enumeration Date | 11/29/2017 |
| Last Update Date | 04/20/2018 |
| Medicare PECOS PAC ID | 9739448895 |
|---|---|
| Medicare Enrollment ID | O20180117001825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134633092 | NPI | - | NPPES |
| 5932X | Other | FL | FLORIDA BLUE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY7991 (Florida) | Primary |
| 103TC0700X | Psychologist - Clinical | PY7991 (Florida) | Secondary |
| Provider Name | Edwin L Bercaw |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871820233 PECOS PAC ID: 3779622014 Enrollment ID: I20091201000234 |
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