Bacchus, Alban Berkley

Bacchus, Alban Berkley is an sole proprietor health care provider with primary practice located at 2889 10Th Ave N Suite 301, Palm Springs FL 33461-3045. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bacchus, Alban Berkley can be contacted via phone (561) 966-2303.

Contact Information

Primary practice address
2889 10Th Ave N Suite 301 Palm Springs FL 33461-3045
Phone: (561) 966-2303
Fax: (561) 966-0714
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0054352 Florida

Profile Details

NPI number 1710176474
LBN Legal business name Bacchus, Alban Berkley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2007
Last updated Oct 18th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710176474 NPPES
Florida MEDICAID 063148500

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