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NPI Code Detail

MEDICARE: DONNA BEREZOWSKI PA

MEDICARE:   DONNA  BEREZOWSKI  PA
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
1363A00000XPhysician AssistantFL
2363AM0700XMedical Physician AssistantPA112354FL

Other Identifiers

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

General Provider Information

NPI Number : 1558926394
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA BEREZOWSKI PA
Provider Business Mailing Address
First Line : 2917 W CASS ST
Second Line :
City : TAMPA
State : FL
Zip : 33609-1608
Country : US
Telephone Number : 813-481-3376
Fax Number :
Provider Business Practice Location Address
First Line : 1600 SW ARCHER RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-1608
Country : US
Telephone Number : 522-650-3353
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2019
Last Update Date : 12/09/2020

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Directions to “ DONNA BEREZOWSKI PA” Practice Location

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