1508466897 NPI number — DR. THEODORE EDWARD BERLINGERI D.C.

Table of content: DR. THEODORE EDWARD BERLINGERI D.C. (NPI 1508466897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508466897 NPI number — DR. THEODORE EDWARD BERLINGERI D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERLINGERI
Provider First Name:
THEODORE
Provider Middle Name:
EDWARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508466897
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
126 9TH AVE NE APT 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ST PETERSBURG
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33701-1860
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-490-8068
Provider Business Mailing Address Fax Number:
727-677-9602

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 TYRONE BLVD N FL 33701
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33710-7128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-490-8068
Provider Business Practice Location Address Fax Number:
727-677-9602
Provider Enumeration Date:
10/27/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  CH13269 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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