MEDICARE: DR. HERBERT MORTON BERTRAM III 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	207X00000X	Orthopaedic Surgery Physician	35059268	OH
2	207X00000X	Orthopaedic Surgery Physician	ME78271	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
2	49133	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588649586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT MORTON BERTRAM III MD

Provider Business Mailing Address
First Line	:	PO BOX 8569
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34101-8569
Country	:	US
Telephone Number	:	239-624-0400
Fax Number	:	239-624-0464

Provider Business Practice Location Address
First Line	:	311 9TH ST N STE 101
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34102-5886
Country	:	US
Telephone Number	:	239-624-1700
Fax Number	:	239-624-1751

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	07/10/2020

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