Provider Demographics
NPI:1811994544
Name:BERKOWITZ, RICHARD DAVID (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:DAVID
Last Name:BERKOWITZ
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 1:7171 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2902
Mailing Address - Country:US
Mailing Address - Phone:954-718-7776
Mailing Address - Fax:954-597-7773
Practice Address - Street 1:7171 N UNIVERSITY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2902
Practice Address - Country:US
Practice Address - Phone:954-718-7776
Practice Address - Fax:954-597-7773
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 71454207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG12996Medicare UPIN
FL32382AMedicare PIN