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General NPI Number Information
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NPI Number | 1356537690
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Entity Type | Organization
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Legal Business Name | H MORTON BERTRAM III MD
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 1009 CROSSPOINTE DR SUITE #2
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City | NAPLES
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State | FL
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Zip | 34110-0930
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Country | US
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Telephone | 239-592-0373
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Fax | 239-593-1391
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Provider Business Mailing Address
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Address Line | PO BOX 112649
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City | NAPLES
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State | FL
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Zip | 34108-0145
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Country | US
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Telephone | 239-592-0373
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Fax | 239-593-1391
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Authorized Official
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Title or Position | OWNER
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Name | DR. HERBERT MORTON BERTRAM, III
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Credential | M.D.
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Telephone | 239-592-0373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | ME69049
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME78271
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License Number State | FL
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