MEDICARE: PAMALA BERMAN

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	225700000X	Massage Therapist	MA43415	FL
2	225700000X	Massage Therapist
3	225X00000X	Occupational Therapist
4	225X00000X	Occupational Therapist	OT9257	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	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	:	1619024783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMALA BERMAN

Provider Business Mailing Address
First Line	:	6580 GRANT COURT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5844
Country	:	US
Telephone Number	:	954-966-2975
Fax Number	:

Provider Business Practice Location Address
First Line	:	6580 GRANT CT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-5844
Country	:	US
Telephone Number	:	954-966-2975
Fax Number	:

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	09/04/2024

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Directions to “ PAMALA BERMAN ” Practice Location

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