Healthcare Provider Details

I. General information

NPI: 1639367642
Provider Name (Legal Business Name): BERC SARAFIAN P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 W BAY DR SUITE 6
LARGO FL
33770-3022
US

IV. Provider business mailing address

2810 W SAINT ISABEL ST SUITE 201
TAMPA FL
33607-6375
US

V. Phone/Fax

Practice location:
  • Phone: 727-584-1344
  • Fax: 727-584-7855
Mailing address:
  • Phone: 813-890-8004
  • Fax: 727-518-0762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License NumberME46578
License Number StateFL

VIII. Authorized Official

Name: DR. BERC SARAFIAN
Title or Position: PRESIDENT
Credential: MD
Phone: 813-890-8004