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General NPI Number Information
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NPI Number | 1144335472
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Entity Type | Organization
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Legal Business Name | IVAN BEREND MD PA
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 21097 NE 27TH COURT SUITE 320
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City | AVENTURA
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State | FL
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Zip | 33180-3329
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Country | US
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Telephone | 305-538-8660
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Fax | 305-538-8667
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Provider Business Mailing Address
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Address Line | 975 ARTHUR GODFREY RD SUITE 408
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3329
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Country | US
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Telephone | 305-538-8660
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Fax | 305-538-8667
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Authorized Official
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Title or Position | PRESIDENT
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Name | IVAN A BEREND
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Credential | MD
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Telephone | 305-538-8660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME79620
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License Number State | FL
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