Healthcare Provider Details

I. General information

NPI: 1063654671
Provider Name (Legal Business Name): BHRT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2009
Last Update Date: 03/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 PGA BLVD SUITE 300
PALM BEACH GARDENS FL
33410-2821
US

IV. Provider business mailing address

3300 PGA BLVD SUITE 300
PALM BEACH GARDENS FL
33410-2821
US

V. Phone/Fax

Practice location:
  • Phone: 888-804-1632
  • Fax: 888-804-1636
Mailing address:
  • Phone: 888-804-1632
  • Fax: 888-804-1636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME45620
License Number StateFL

VIII. Authorized Official

Name: DR. MIKHAIL BERMAN
Title or Position: DIRECTOR
Credential: M.D.
Phone: 888-804-1632