Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME106116 | FL |
NPI | 1104009067 |
---|---|
Provider Name | Dr. Ezra A Berkowitz |
First Address | Atlantis, FL 33462-6641 |
Second Address | Atlantis, FL 33462-6641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2007 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002397500 | (05) | FL |
1104009067 | NPI (01) |