Provider Demographics
NPI:1427264258
Name:BERKE, WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:BERKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 NE MIAMI GARDENS DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4845
Mailing Address - Country:US
Mailing Address - Phone:305-940-7546
Mailing Address - Fax:305-940-4611
Practice Address - Street 1:1400 NE MIAMI GARDENS DR
Practice Address - Street 2:SUITE 202
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4845
Practice Address - Country:US
Practice Address - Phone:305-940-7546
Practice Address - Fax:305-940-4611
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0026457207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD86514Medicare UPIN
FL95624Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO