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General NPI Number Information
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NPI Number | 1871891739
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Entity Type | Organization
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Legal Business Name | CLAYTON M. BERGER, M.D., P.A.
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 201 SE 14TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-1827
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Country | US
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Telephone | 954-525-1111
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Fax | 954-522-5588
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Provider Business Mailing Address
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Address Line | 201 SE 14TH ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-1827
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Country | US
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Telephone | 954-525-1111
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Fax | 954-522-5588
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLAYTON M BERGER
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Credential | MD
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Telephone | 954-525-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number | ME0051926
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License Number State | FL
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