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General NPI Number Information
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NPI Number | 1558926394
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Entity Type | Individual
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Provider Name | DONNA BEREZOWSKI PA
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Gender | Female
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-1608
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Country | US
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Telephone | 522-650-3353
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Fax |
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Provider Business Mailing Address
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Address Line | 2917 W CASS ST
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City | TAMPA
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State | FL
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Zip | 33609-1608
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Country | US
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Telephone | 813-481-3376
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA112354
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License Number State | FL
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