DR. GARY LEE BERGER (NPI# 1205818804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205818804 |
| Entity Type | Individual |
| Full Name | DR. GARY LEE BERGER |
| Credential | MD |
| Practice Address |
2400 Harbor Blvd Suite 21 Port Charlotte FL 33952-5052 |
| Mailing Address |
2234 Colonial Blvd Managed Care Department Fort Myers FL 33907-1412 |
| Practice Telephone | 9416256992 |
| Practice Fax Number | 9416257238 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2016-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | ME0030516 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 002736800 | 05 | |
| FL | WELLCARE | 1192904 | 01 |
| FL | AVMED | 217124 | 01 |
| FL | CIGNA | 8707000 | 01 |
| FL | CIGNA PROVIDER # | 8707000 | 01 |
| FL | BCBS OF FL | 47450 | 01 |
| FL | BCBS PROVIDER # | 25028 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174774624 | Gary Berger | Pharmacist | 1630 Old Deerfield Rd, Suite 202, Highland Park, IL 60035-3027 | 2008-10-02 |
| 1750991964 | Gary Lee Berger Jr. | Counselor | 311 E Market St Fl 3, Lima, OH 45801-4535 | 2020-08-03 |
| 1376847665 | Gary H Berger | Pharmacist | 710 Broadway, Santa Monica, CA 90401-2608 | 2010-12-31 |
| 1588867352 | Gary Sterling Berger | Specialist | 109 Conner Dr, Suite 2200, Chapel Hill, NC 27514-7039 | 2007-06-07 |
| 1699812966 | Gary Ryan Berger | Ophthalmology | 235 Se Norton Ln, Suite A, Mcminnville, OR 97128-8479 | 2007-01-30 |
| 1386729721 | Gary D Berger | Optometrist | 10 E 1300 S, Richfield, UT 84701 | 2006-10-26 |
| 1154351799 | Gary Steven Berger | Plastic Surgery | 114 E 71st St, Suite 12, New York, NY 10021-5040 | 2006-07-03 |
| 1740259019 | Gary Berger | Family Medicine | 8 Shunpike Rd, Madison, NJ 07940-2740 | 2006-03-17 |
| Street Address |
2400 HARBOR BLVD SUITE 21 |
| City | PORT CHARLOTTE |
| State | FL |
| Zip Code | 33952-5052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063406445 | Janet M Tobin Md Pa | Family Medicine | 2400 Harbor Blvd, Ste 13, Port Charlotte, FL 33952-5052 | 2005-08-31 |
| 1962701672 | Maternal Fetal Medicine of S.w. Fl | Obstetrics & Gynecology | 2400 Harbor Blvd, Unit 7, Port Charlotte, FL 33952-5038 | 2011-03-21 |
| 1023328135 | B Adhinarayanan Md Pa | Internal Medicine | 2400 Harbor Blvd, Suite 16, Port Charlotte, FL 33952 | 2010-10-08 |
| 1790091692 | O Sambandam Md Pa | Internal Medicine | 2400 Harbor Blvd, Suite 8, Port Charlotte, FL 33952-5052 | 2010-08-30 |
| 1598076143 | Adelina C. Flores, M.d. P.a. | Specialist | 2400 Harbor Blvd, Suite 12, Port Charlotte, FL 33952-5052 | 2010-06-29 |
| 1245562677 | Muhammed Y Memon Md Pa | Neurological Surgery | 2400 Harbor Blvd, Ste 10, Port Charlotte, FL 33952-5052 | 2010-02-10 |
| 1215260534 | Michael A, Coffey Md Pa | Obstetrics & Gynecology | 2400 Harbor Blvd, Suite 14, Port Charlotte, FL 33952-5052 | 2009-09-18 |
| 1144455734 | William R Salazar Md Chartered | Internal Medicine | 2400 Harbor Blvd, Ste 1, Port Charlotte, FL 33952-5052 | 2009-05-26 |
| 1801066873 | Nutegra Mental Health and Nutrition Inc | Dietitian, Registered | 2400 Harbor Blvd, Suite 20, Port Charlotte, FL 33952-5052 | 2008-03-06 |
| 1568632453 | Nasir Khalidi & Sakina Khalidi, Md Pa | Obstetrics & Gynecology | 2400 Harbor Blvd, Suite 17, Port Charlotte, FL 33952-5052 | 2008-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486552 | Arrow Medical LLC | Durable Medical Equipment & Medical Supplies | 3514 Tamiami Trail, Unit 104, Port Charlotte, FL 33952 | 2020-10-30 |
| 1376009621 | David Alan Mowry | Massage Therapist | 3148 Whiting Lane, Port Charlotte, FL 33952 | 2019-02-12 |
| 1124527189 | Aegis Group Practice, LLC | Physical Therapist | 2500 Aaron Street, Port Charlotte, FL 33952 | 2018-02-06 |
| 1255856118 | All Powered Mobility, LLC | Durable Medical Equipment & Medical Supplies | 2765 Tamiami Trl Ste B1, Port Charlotte, FL 33952 | 2017-08-11 |
| 1366994915 | Julianne Kumar | Physical Medicine & Rehabilitation | 4166 Tamiami Trail, Unit A, Port Charlotte, FL 33952 | 2016-10-31 |
| 1659729549 | The Gathering Place LLC | Licensed Practical Nurse | 3459 Depew Ave, Port Charlotte, FL 33952 | 2016-06-01 |
| 1003222183 | Philip Lagamma | Physical Therapist | 4161 Tamiami Trl Ste 103, Port Charlotte, FL 33952 | 2014-07-09 |
| 1184039695 | Nathan E Shipley | Driver | 2338 Alton Rd., Port Charlotte, FL 33952 | 2014-06-23 |
| 1619318219 | Nic 4 Royal Palm Leasing LLC | Assisted Living Facility | 2500 Aaron St., Port Charlotte, FL 33952 | 2013-07-11 |
| 1225306475 | Tamjo Inc | Hearing Instrument Specialist | 2811 Ste. A Tamiami Trail, Port Charlotte, FL 33952 | 2011-12-02 |
| Find all providers in zip 33952 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720469596 | Crystal Smedley | Urology | 2400 Harbor Blvd Ste 21, Port Charlotte, FL 33952-5038 | 2015-06-17 |
| 1164669404 | Jens C. Carlsen | Urology | 2525 Harbor Blvd Ste 301, Port Charlotte, FL 33952-5342 | 2009-01-08 |
| 1659569994 | Ekiong Chua Tan | Urology | 13435 S Mccall Rd Unit 16, Ste 397, Port Charlotte, FL 33981-6421 | 2007-10-11 |
| 1437697646 | Jens Christian Carlsen Do Pllc | Urology | 2525 Harbor Blvd, Ste. 301, Port Charlotte, FL 33952-5317 | 2017-02-08 |
| 1255741880 | Genesiscare Usa of Florida LLC | Urology | 21260 Olean Blvd, Suite 202a, Port Charlotte, FL 33952-6742 | 2014-05-05 |
| 1518278555 | 21st Century Oncology LLC | Urology | 3390 Tamiami Trl, Suite 201, Port Charlotte, FL 33952-8157 | 2010-06-24 |
| 1043465099 | Genesiscare Usa of Florida LLC | Urology | 3410 Tamiami Trl, Suite 4, Port Charlotte, FL 33952-8112 | 2008-11-18 |
| 1023193018 | Marc A. Melser, Md, Pl | Urology | 3410 Tamiami Trl, Suite 4, Port Charlotte, FL 33952-8112 | 2006-10-26 |
| 1063480085 | Marc A Melser | Urology | 3410 Tamiami Trl, Suite 4, Port Charlotte, FL 33952-8127 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770193450 | Urotelemedicine LLC | Urology | 8669 Nw 36th St Ste 325, Doral, FL 33166-6698 | 2020-08-06 |
| 1700411618 | Ackerman Cancer Center, Pa | Urology | 159 North 3rd St, Macclenny, FL 32063-2103 | 2020-03-11 |
| 1043844483 | Jesse Aaron Ory | Urology | 5555 Ponce De Leon Blvd Fl 4, Coral Gables, FL 33146-2513 | 2020-02-25 |
| 1215591565 | Advent Health | Urology | 420 Celebration Ave, Celebration, FL 34747-4683 | 2019-04-23 |
| 1710442264 | Urologic Specialists of Central Florida Pllc | Urology | 575 S Wickham Rd Ste A, West Melbourne, FL 32904-1170 | 2019-02-08 |
| 1578028197 | Prody Urology, Pllc | Urology | 575 S Wickham Rd Ste B, West Melbourne, FL 32904-1170 | 2019-02-07 |
| 1366916843 | Dr. Carolyn Langford Urologic Solutions, LLC | Urology | 9400 Gladiolus Dr Ste 30, Fort Myers, FL 33908-9615 | 2019-01-17 |
| 1376016568 | Advanced Innovative Urology Pa | Urology | 4737 N Ocean Dr Ste 103, Lauderdale By The Sea, FL 33308-2920 | 2019-01-10 |
| 1306314281 | Urology Consultants of Boca Raton Pa | Urology | 825 Meadows Rd Ste 111, Boca Raton, FL 33486-2347 | 2018-11-08 |
| 1013490309 | Seetharam Bhat Kulthe Ramesh | Urology | 401 Celebration Pl Ste 200, Celebration, FL 34747-4971 | 2018-09-12 |
| Find all providers with the same taxonomy | ||||
| City | PORT CHARLOTTE |
| Zip Code | 33952 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.