DR. BEDFORD HUDSON BERREY (NPI# 1114988409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114988409 |
| Entity Type | Individual |
| Full Name | DR. BEDFORD HUDSON BERREY |
| Credential | MD |
| Practice Address |
1301 Palm Ave Jacksonville FL 32207-8432 |
| Mailing Address |
Po Box 45278 Jacksonville FL 32232-5278 |
| Practice Telephone | 9042027300 |
| Practice Fax Number | 9042027433 |
| Mailing Telephone | 9042022092 |
| Mailing Fax Number | 9043937603 |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2019-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | ME74636 | FL | Allopathic & Osteopathic Physicians |
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
ME74636 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 2505126-00 | 05 | |
| GA | 000809718B | 05 | |
| RR CARE | 200044245 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1325 San Marco Blvd Ste 200, Jacksonville, FL 322078566 | 9043463465 | 9043960388 |
| Street Address |
1301 PALM AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134112261 | Russell B Smith | Otolaryngology | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2005-08-24 |
| 1669096897 | Kimberly Nguyen Blythe | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2020-06-03 |
| 1609409945 | Emma Kate Alpert | Physician Assistant | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2020-02-14 |
| 1053964403 | Caitlyn Mitchell | Genetic Counselor, MS | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2019-07-24 |
| 1972167740 | Jessica C Terrell | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2019-04-27 |
| 1689135998 | Ghazal S Vafabakhsh | Physician Assistant | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2019-03-28 |
| 1710456215 | Jacquelene Marie Carson | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2018-11-14 |
| 1770059008 | Leslie Shannan Weaver | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2018-10-14 |
| 1659852325 | Patrick Alan Regis | Nurse Practitioner | 1301 Palm Ave, Jacksonville, FL 32207-8432 | 2018-08-22 |
| 1568941276 | Baptist-southeast Gynecologic Oncology Associates Inc | Internal Medicine | 1301 Palm Ave, Jacksonville, FL 32207 | 2018-08-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083968028 | Southern Surgical Specialties LLC | Surgery | 5210 Belfort Rd, Suite 130, Jacksonville, FL 32256-6024 | 2012-10-30 |
| 1215101902 | 21st Century Oncology of Jacksonville LLC | Surgery | 1235 San Marco Blvd, Suite 3, Jacksonville, FL 32207-8554 | 2008-04-15 |
| 1972510592 | Carmine M Volpe | Surgery | 655 W 8th St, Ufjp Surgery Department, Jacksonville, FL 32209-6511 | 2006-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162228 | Florida Surgical Care LLC | Surgery | 2301 N University Dr Ste 204, Pembroke Pines, FL 33024-3617 | 2020-10-23 |
| 1699234534 | Breast Specialists of South Florida, LLC | Surgery | 130 Jfk Dr Ste 132, Atlantis, FL 33462-1133 | 2019-03-19 |
| 1659755783 | Genesiscare Usa of Florida LLC | Surgery | 8925 Colonial Center Dr Ste 2000, Fort Myers, FL 33905-7813 | 2015-07-18 |
| 1114365244 | Ahkeel Ikadon Hasani Allen | Surgery | 7500 Sw 87th Ave Ste 201, Miami, FL 33173-5426 | 2013-06-11 |
| 1003150889 | Daniel A. Osman | Surgery | 2456 Bay Isle Ct, Weston, FL 33327-1410 | 2012-11-19 |
| 1073834883 | David H Owen Md Pa | Surgery | 2623 S Seacrest Blvd Ste 108, Boynton Beach, FL 33435-7531 | 2010-06-15 |
| 1598082521 | Neha Goel | Surgery | 1120 Nw 14th St Ste 450, Miami, FL 33136 | 2010-04-30 |
| 1235373846 | Paris Sabo | Surgery | 2109 60th St W Ste A, Bradenton, FL 34209-5526 | 2009-04-27 |
| 1356582381 | Bassan Jorge Allan | Surgery | 4571 Colonial Blvd Ste 100, Fort Myers, FL 33966 | 2009-03-21 |
| 1043474125 | Mount Sinai Medical Center Surgical Oncology, LLC | Surgery | 4306 Alton Rd Fl 2, Comprehensive Cancer Center, Miami Beach, FL 33140-2840 | 2008-07-17 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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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.