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General NPI Number Information
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NPI Number | 1023234507
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Entity Type | Individual
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Provider Name | JUAN A BEREAO MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 10/15/2009
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Provider Practice Location Address
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Address Line | 8352 SW 8TH ST
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City | MIAMI
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State | FL
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Zip | 33144-4180
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Country | US
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Telephone | 305-262-8282
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 650942
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City | MIAMI
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State | FL
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Zip | 33265-0942
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Country | US
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Telephone | 305-262-8282
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | ME97447
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License Number State | FL
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