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General NPI Number Information
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NPI Number | 1124096946
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Entity Type | Individual
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Provider Name | ROBERT J BERTOT PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 14150 SW 136TH ST
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City | MIAMI
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State | FL
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Zip | 33186-5506
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Country | US
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Telephone | 786-888-8820
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Fax |
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Provider Business Mailing Address
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Address Line | 10535 NW 43RD TER
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City | DORAL
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State | FL
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Zip | 33178-2265
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Country | US
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Telephone | 786-514-8893
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9104718
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License Number State | FL
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