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General NPI Number Information
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NPI Number | 1356351605
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Entity Type | Organization
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Legal Business Name | BERAJA MEDICAL INSTITUTE INC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 2550 S DOUGLAS RD
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City | CORAL GABLES
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State | FL
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Zip | 33134-6126
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Country | US
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Telephone | 305-443-7070
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Fax | 305-357-1701
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Provider Business Mailing Address
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Address Line | 44 BARKLEY CIR
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City | FORT MYERS
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State | FL
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Zip | 33907-7530
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Country | US
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Telephone | 239-985-7171
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Fax | 392-985-7118
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Authorized Official
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Title or Position | DIRECTOR
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Name | THOMAS ALBERT QUIGLEY
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Credential |
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Telephone | 239-466-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | FL
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