| Berland Medical Group Llc | |
|
11792 Lake Aston Ct Ste A Tampa FL 33626-3135 | |
| (813) 690-0225 | |
| (877) 992-6777 |
| Full Name | Berland Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 11792 Lake Aston Ct Ste A, Tampa, Florida |
| Authorized Official Name and Position | Gregory A Berland (OWNER) |
| Authorized Official Contact | 8136900225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Berland Medical Group Llc 2410 Northside Dr Clearwater FL 33761-2236 Ph: (727) 499-0356 | Berland Medical Group Llc 11792 Lake Aston Ct Ste A Tampa FL 33626-3135 Ph: (813) 690-0225 |
| NPI Number | 1376052019 |
|---|---|
| Provider Enumeration Date | 09/26/2017 |
| Last Update Date | 09/26/2017 |
| Medicare PECOS PAC ID | 4789942723 |
|---|---|
| Medicare Enrollment ID | O20171220000570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376052019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME83967 (Florida) | Primary |
| Provider Name | Cari L Caraway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184793192 PECOS PAC ID: 7719878164 Enrollment ID: I20040324000010 |
| Provider Name | Gregory A Berland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265427405 PECOS PAC ID: 5597744797 Enrollment ID: I20040720000091 |
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