MEDICARE: DR. RICHARD A. BERMAN O.D.

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	152W00000X	Optometrist	OPC3211	FL

General Provider Information

NPI Number	:	1861533804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD A. BERMAN O.D.

Provider Business Mailing Address
First Line	:	4112 OXBOW DR
Second Line	:
City	:	COCONUT CREEK
State	:	FL
Zip	:	33073-5116
Country	:	US
Telephone Number	:	954-675-7447
Fax Number	:

Provider Business Practice Location Address
First Line	:	4635 N UNIVERSITY DR
Second Line	:	C/O FOR EYES OPTICAL
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4602
Country	:	US
Telephone Number	:	954-905-3474
Fax Number	:	954-227-2898

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

Provider Enumeration Date	:	02/11/2007
Last Update Date	:	09/20/2014

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