Provider Demographics
NPI:1427826890
Name:BERGER, MICHAEL THOMAS
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:THOMAS
Last Name:BERGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 N CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6007
Mailing Address - Country:US
Mailing Address - Phone:801-791-7934
Mailing Address - Fax:
Practice Address - Street 1:601 SW 8TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-3209
Practice Address - Country:US
Practice Address - Phone:786-362-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist