MEDICARE: SCOTT BERENSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME00041592	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	237231	OTHER	FL	AVMED
2	0498895	OTHER	FL	AETNA
3	29121	OTHER	FL	NEIGHBORHOOD HEALTH PLAN
4	0016689	OTHER	FL	GHI
5	0501319010	OTHER	FL	CIGNA
6	0402137	OTHER	FL	UHC
7	1044836	OTHER	FL	CAREPLUS
8	94342	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1134126907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT BERENSON MD

Provider Business Mailing Address
First Line	:	9970 CENTRAL PARK BLVD N
Second Line	:	SUITE 404
City	:	BOCA RATON
State	:	FL
Zip	:	33428-2231
Country	:	US
Telephone Number	:	561-483-1125
Fax Number	:	561-483-9267

Provider Business Practice Location Address
First Line	:	9970 CENTRAL PARK BLVD N
Second Line	:	SUITE 404
City	:	BOCA RATON
State	:	FL
Zip	:	33428-2231
Country	:	US
Telephone Number	:	561-483-1125
Fax Number	:	561-483-9267

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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Directions to “ SCOTT BERENSON MD” Practice Location

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