MEDICARE: DR. ROBERTO BERAJA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	ME39484	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275696627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERTO BERAJA MD

Provider Business Mailing Address
First Line	:	44 BARKLEY CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-7530
Country	:	US
Telephone Number	:	239-985-7171
Fax Number	:	239-985-7118

Provider Business Practice Location Address
First Line	:	2550 S DOUGLAS RD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-6104
Country	:	US
Telephone Number	:	305-357-1711
Fax Number	:	305-357-1701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	04/19/2023

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