Lawrence Russell Bergman M.D.

NPI 1073518130 - Pediatrics - 2080A0000X

NPI Details
NPI 1073518130
Gender Male
Enumeration Date 06/16/2005
Last Updated 09/21/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
10115 W FOREST HILL BLVD
STE 303
WELLINGTON FL, 33414-3102, US
Phone (561) 798-5565
Fax (561) 798-9756
Business Location
10115 W FOREST HILL BLVD
STE 303
WELLINGTON FL, 33414-3102, US
Phone (561) 798-5565
Fax (561) 798-9756
Toxanomy
Taxonomy Code 2080A0000X
License State Florida
License Number ME56164
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According to our database, Dr. Lawrence Russell Bergman M.D. NPI is 1073518130, taxonomy code is 2080A0000X and license number is ME56164, license state is located at Florida. Lawrence Russell Bergman M.D. physically located at 10115 W Forest Hill Blvd, Wellington FL, 33414-3102. NPI Number Lawrence Russell Bergman M.D. has the Individual type.

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1073518130 NPI number is provided on an as is basis without warranty of any kind. 1073518130 is maintained by the National Plan & Provider Enumeration System. The contents of Lawrence Russell Bergman M.D. are for informational purposes only.