Dr. Leslie Robert Berghash
Facial Plastic Surgeon
1801 Se Hillmoor Dr Suite B105
Port St Lucie
, Florida 34952-7545
Dr. Leslie Robert Berghash
Facial Plastic Surgeon
1801 Se Hillmoor Dr Suite B105
Port St Lucie
, Florida 34952-7545
(772) 398-4374
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About
Features
Specialties
- Facial Plastic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Leslie Robert Berghash
- 1801 Se Hillmoor Dr Suite B105
- Port St Lucie, FL
- Zip : 34952-7545
- Fax : (772) 398-4374
- Phone : (772) 398-9911
Second Address
- Dr. Leslie Robert Berghash
- 1801 Se Hillmoor Dr Suite B105
- Port St Lucie, FL
- Zip : 34952-7545
- Fax : (772) 398-4374
- Phone : (772) 398-9911
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YS0123X | Facial Plastic Surgeon | ME0052176 | FL |
National Provider Identifier
| NPI | 1255420485 |
|---|---|
| Provider Name | Dr. Leslie Robert Berghash |
| First Address | Port St Lucie, FL 34952-7545 |
| Second Address | Port St Lucie, FL 34952-7545 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/10/2006 |
| Last Update Date | 23/09/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 255062800 | (05) | FL |
| B72226 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.