| Ronald L. Bergman, Ph.d., P.a. | |
|
2627 Ne 203rd St S-214 Miami FL 33180-1900 | |
| (305) 932-3666 | |
| Not Available |
| Full Name | Ronald L. Bergman, Ph.d., P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 2627 Ne 203rd St, Miami, Florida |
| Authorized Official Name and Position | Ronald L Bergman (PRESIDENT) |
| Authorized Official Contact | 3059323666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald L. Bergman, Ph.d., P.a. 2627 Ne 203rd St S-214 Miami FL 33180-1900 Ph: (305) 932-3666 | Ronald L. Bergman, Ph.d., P.a. 2627 Ne 203rd St S-214 Miami FL 33180-1900 Ph: (305) 932-3666 |
| NPI Number | 1023332764 |
|---|---|
| Provider Enumeration Date | 03/24/2010 |
| Last Update Date | 03/24/2010 |
| Medicare PECOS PAC ID | 7719018381 |
|---|---|
| Medicare Enrollment ID | O20100625000136 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023332764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY2048 (Florida) | Primary |
| Provider Name | Ronald L Bergman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013980788 PECOS PAC ID: 3971634544 Enrollment ID: I20100825000865 |
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