MEDICARE: DR. GARY BERMAN O.D.

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	152W00000X	Optometrist	OPC2870	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	GO144Y	OTHER	FL	MEDICARE PTAN

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306857420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY BERMAN O.D.

Provider Business Mailing Address
First Line	:	4815 NW 183RD ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-2955
Country	:	US
Telephone Number	:	305-621-3830
Fax Number	:	305-621-3831

Provider Business Practice Location Address
First Line	:	4815 NW 183RD ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33055-2955
Country	:	US
Telephone Number	:	305-621-3830
Fax Number	:	305-621-3831

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	04/30/2025

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Directions to “ DR. GARY BERMAN O.D.” Practice Location

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