Healthcare Provider Details

I. General information

NPI: 1558388405
Provider Name (Legal Business Name): LAWRENCE A BERGER MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SE 4TH AVE STE 504
HALLANDALE BEACH FL
33009-6494
US

IV. Provider business mailing address

800 SE 4TH AVE STE 504
HALLANDALE BEACH FL
33009-6494
US

V. Phone/Fax

Practice location:
  • Phone: 305-932-5551
  • Fax: 305-932-2397
Mailing address:
  • Phone: 305-932-5551
  • Fax: 305-932-2397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME0051685
License Number StateFL

VIII. Authorized Official

Name: LAWRENCE A BERGER
Title or Position: OWNER
Credential: MD
Phone: 305-932-5551