MEDICARE: DR. ALBERT BERJE 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	2085R0202X	Diagnostic Radiology Physician	ME16765	FL
2	208D00000X	General Practice Physician	ME 16765	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326036351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT BERJE MD

Provider Business Mailing Address
First Line	:	2901 67TH AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33712-5520
Country	:	US
Telephone Number	:	727-289-9530
Fax Number	:

Provider Business Practice Location Address
First Line	:	2901 67TH AVE S
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33712-5520
Country	:	US
Telephone Number	:	727-289-9530
Fax Number	:

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	05/29/2015

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Directions to “ DR. ALBERT BERJE MD” Practice Location

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