| Dr Leslie Robert Berghash, MD | |
|
1801 Se Hillmoor Dr, Suite B105, Port St Lucie, FL 34952-7545 | |
| (772) 398-9911 | |
| (772) 398-4374 |
| Full Name | Dr Leslie Robert Berghash |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology - Facial Plastic Surgery |
| Location | 1801 Se Hillmoor Dr, Port St Lucie, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255420485 | NPI | - | NPPES |
| 255062800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207YS0123X | Otolaryngology - Facial Plastic Surgery | ME0052176 (Florida) | Primary |
| Entity Name | Ent And Allergy Associates Of Florida, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164473120 PECOS PAC ID: 0042292849 Enrollment ID: O20040604000553 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Leslie Robert Berghash, MD 1801 Se Hillmoor Dr, Suite B105, Port St Lucie, FL 34952-7545 Ph: (772) 398-9911 | Dr Leslie Robert Berghash, MD 1801 Se Hillmoor Dr, Suite B105, Port St Lucie, FL 34952-7545 Ph: (772) 398-9911 |
Dr. Daniel J Zaluzec, M.D. Otolaryngology Medicare: Medicare Enrolled Practice Location: 1801 Se Hillmoor Dr Ste C-110, Port St Lucie, FL 34952 Phone: 772-337-0072 Fax: 888-615-7171 | |
Kenneth Weiss, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 10377 S Us Highway 1, Ste 101, Port St Lucie, FL 34952 Phone: 772-337-3700 | |
Dr. Timothy Seth Tudor, D.O. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1801 Se Hillmoor Dr Ste B-105, Port St Lucie, FL 34952 Phone: 772-398-9911 Fax: 772-398-4577 | |
William Bernard Bass, ARNP Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 1801 Se Hillmoor Dr Ste B-105, Port St Lucie, FL 34952 Phone: 772-398-9911 Fax: 772-398-4374 | |
Dr. John T Lanza, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1801 Se Hillmoor Dr, Suite B105, Port St Lucie, FL 34952 Phone: 772-398-9911 Fax: 772-398-4374 |