Provider Demographics
NPI:1093862872
Name:SCOTT A BERGER MD PA
Entity type:Organization
Organization Name:SCOTT A BERGER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-962-9600
Mailing Address - Street 1:PO BOX 8199
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33482-8199
Mailing Address - Country:US
Mailing Address - Phone:561-962-9600
Mailing Address - Fax:561-962-9601
Practice Address - Street 1:7815 NW BEACON SQUARE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1345
Practice Address - Country:US
Practice Address - Phone:561-962-9600
Practice Address - Fax:561-962-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0058045207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40151Medicare ID - Type Unspecified