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General NPI Number Information
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NPI Number | 1336209667
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Entity Type | Individual
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Provider Name | GLEN BERMAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 8333 W MCNAB RD
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City | TAMARAC
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State | FL
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Zip | 33321-3242
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Country | US
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Telephone | 954-726-8424
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Fax | 954-572-4409
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Provider Business Mailing Address
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Address Line | 8333 W MCNAB RD STE 128
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City | TAMARAC
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State | FL
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Zip | 33321-3203
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Country | US
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Telephone | 954-726-8424
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Fax | 954-572-4409
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH0006313
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License Number State | FL
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