MEDICARE: DR. PETER B BERKEY M.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	207RI0200X	Infectious Disease Physician	ME132416	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	440003595	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	3401982	OTHER	UNITED HEALTHCARE
2	WS365	OTHER	OXFORD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	09727P	OTHER	HIP
5	0D1595	OTHER	HEALTHNET
7	0000924	OTHER	GHI
8	0915351	OTHER	AETNA AND US HEALTHCARE

General Provider Information

NPI Number	:	1881761245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER B BERKEY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 100 DEPT#394
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38148-0001
Country	:	US
Telephone Number	:	941-300-4440
Fax Number	:	941-404-1760

Provider Business Practice Location Address
First Line	:	315 SE 14TH ST
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1929
Country	:	US
Telephone Number	:	954-701-6920
Fax Number	:	855-643-6201

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	02/13/2024

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Directions to “ DR. PETER B BERKEY M.D.” Practice Location

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