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NPI Code Detail

MEDICARE: DR. BRIAN T. BERRY M.D., PHD

MEDICARE: DR. BRIAN T. BERRY M.D., PHD
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
1207RX0202XMedical Oncology PhysicianME73368FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1830008377OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
241393OTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669463378
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN T. BERRY M.D., PHD
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line :
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8200
Fax Number :
Provider Business Practice Location Address
First Line : 3630 MANATEE AVE W
Second Line :
City : BRADENTON
State : FL
Zip : 34205-2557
Country : US
Telephone Number : 941-792-1881
Fax Number : 941-795-3924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 03/04/2026

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