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General NPI Number Information
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NPI Number | 1730157678
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Entity Type | Individual
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Provider Name | ERNEST GEORGE BERTHA MD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 3000 CORAL HILLS DR
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-4108
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Country | US
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Telephone | 954-344-3100
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Fax | 919-425-0478
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Provider Business Mailing Address
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Address Line | 3114 CROASDAILE DR SUITE 200
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City | DURHAM
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State | NC
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Zip | 27705-2508
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Country | US
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Telephone | 877-751-1157
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Fax | 919-425-0478
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME97151
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME97151
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | ME97151
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME97151
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License Number State | FL
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