Berry, Jerisa

Berry, Jerisa is an individual health care provider with primary practice located at 11903 Southern Blvd Ste 108 , Royal Palm Beach FL 33411-7644. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Berry, Jerisa can be contacted via phone (561) 793-1475.

Contact Information

Primary practice address
11903 Southern Blvd Ste 108 Royal Palm Beach FL 33411-7644
Phone: (561) 793-1475
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 125049751 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 125049751 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X OS12892 Florida

Profile Details

NPI number 1679760045
LBN Legal business name Berry, Jerisa
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2007
Last updated Feb 27th, 2020 - about 6 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 1679760045 NPPES
Illinois MEDICAID 036119674

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