MEDICARE: DR. STEPHEN L BERKES M.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	2083P0901X	Public Health & General Preventive Medicine Physician	ME25334	FL
2	207R00000X	Internal Medicine Physician	ME 25334	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50724Z	OTHER	FL	PTAN

General Provider Information

NPI Number	:	1386795375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN L BERKES M.D.

Provider Business Mailing Address
First Line	:	3231 GULF GATE DR
Second Line	:	SUITE 101
City	:	SARASOTA
State	:	FL
Zip	:	34231-2406
Country	:	US
Telephone Number	:	941-921-0777
Fax Number	:	941-921-0778

Provider Business Practice Location Address
First Line	:	3231 GULF GATE DR
Second Line	:	SUITE 101
City	:	SARASOTA
State	:	FL
Zip	:	34231-2406
Country	:	US
Telephone Number	:	941-921-0777
Fax Number	:	941-921-0778

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	03/29/2017

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