Provider Demographics
NPI:1932565371
Name:BERMAN, JENNIFER CATHERINE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CATHERINE
Last Name:BERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1595 PINE RIDGE RD # 19
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2127
Mailing Address - Country:US
Mailing Address - Phone:239-593-0663
Mailing Address - Fax:239-593-0664
Practice Address - Street 1:1595 PINE RIDGE RD # 19
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2127
Practice Address - Country:US
Practice Address - Phone:239-593-0663
Practice Address - Fax:239-593-0664
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109245363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical