MR. KEITH A BERENS


Address: 1717 North E Street, Suite 422, Pensacola, FL 32501-6339
Phone: 8504447050

MR. KEITH A BERENS (NPI# 1174505788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1174505788
Entity Type Individual
Full Name MR. KEITH A BERENS
Credential PAC
Practice Address 1717 North E Street
Suite 422
Pensacola
FL 32501-6339
Mailing Address 4441 La Jolla
Pensacola
FL 32504-7839
Practice Telephone 8504447050
Practice Fax Number 8504348879
Mailing Telephone 8502618030
Enumeration Date 2005-11-18
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
PA9101561 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL 291015200 05
FL BSAL 59039584 01

Office Location

Street Address 1717 NORTH E STREET
SUITE 422
City PENSACOLA
State FL
Zip Code 32501-6339

Providers in the same location

NPI Name Taxonomy Address Enumeration
1508367889 Jessica D Nichols Nurse Practitioner 1717 North E Street, Tower 3, Suite 231, Pensacola, FL 32501 2018-02-22
1134509284 Lauren A Elsas Nurse Practitioner 1717 North E Street, Ste 300, Pensacola, FL 32501-6336 2015-06-04
1427317882 Andrew J Vincent Radiology 1717 North E Street, Ste 300, Pensacola, FL 32501-6336 2012-05-04
1699973834 Pensacola Radiation Medicine P.a. Radiology 1717 North E Street, Suite 134, Pensacola, FL 32501-6339 2007-07-10
1336155977 Peter Arthur Courcy Surgery 1717 North E Street, Suite 205, Pensacola, FL 32501-6336 2006-08-01
1326069113 George Crosby Rees Surgery 1717 North E Street, Suite 205, Pensacola, FL 32501-6336 2006-07-21
1306867197 Ming Ming Zhang Surgery 1717 North E Street, Suite 205, Pensacola, FL 32501-6336 2006-07-21
1891731188 David R Downey Physician Assistant 1717 North E Street, Ste 534, Pensacola, FL 32501-6342 2006-06-22
1164480240 Pensacola Ear Nose and Throat Pl Otolaryngology 1717 North E Street, Ste 239, Pensacola, FL 32501 2006-05-01
1013977941 Langhorne Cardiology Consultants, Inc. Internal Medicine 1717 North E Street, Suite 331, Pensacola, FL 32501 2006-03-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1669084976 Steven Bollen Pharmacist 870 E Cervantes, Pensacola, FL 32501 2020-08-18
1013558733 Erica Watts Social Worker 901 North I Street, Pensacola, FL 32501 2019-10-03
1972164598 Yabin Chen Student in an Organized Health Care Education/Training Program Fairfield Pediatrics, 1295 W. Fairfield Drive, Pensacola, FL 32501 2019-06-25
1336700038 Michael Enriquez Student in an Organized Health Care Education/Training Program Fairfield Pediatrics- Community Health Nw Fl, 1295 W Fairfield Drive, Pensacola, FL 32501 2019-06-24
1336631803 Ana Andreea Curta Student in an Organized Health Care Education/Training Program Community Health Northwest Florida, 1295 W. Fairfield Drive, Pensacola, FL 32501 2018-05-31
1700374618 Telecia Walker Massage Therapist 1720 W. Fairfield Dr., Ste 309, Pensacola, FL 32501 2018-04-26
1578085254 Mary Holland Hegarty Physical Therapist 1000 W, Moreno St, Pensacola, FL 32501 2017-07-13
1184162455 Wal-mart Stores East Lp Durable Medical Equipment & Medical Supplies 1525 E Nine Mile Road, Pensacola, FL 32501 2017-02-07
1215271564 Pathways for Change, Inc Social Worker 2050 West Blount Street, Pensacola, FL 32501 2012-11-26
1962697342 Martha M Green Family Medicine 1717 N E St Ste 222a, Pensacola, FL 32501 2007-09-10
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1891123378 Donza First Assist Physician Assistant 7225 West Fairfield Dr., C-8, Pensacola, FL 32506-3488 2013-10-21
1366436362 Mark William Houston Physician Assistant 4012 N 9th Ave, Pensacola, FL 32503-2824 2005-09-06
1558355545 Anthony A Zembrzuski Physician Assistant 1717 N E St Ste 530, Pensacola, FL 32501 2005-09-06
1184171258 Madeliene Hill Physician Assistant 1717 N E St, Pensacola, FL 32501-6339 2016-09-07
1497112270 Sherri Peete Physician Assistant 1717 N E St, Pensacola, FL 32501-6339 2016-01-25
1447615554 Jessica Sinco Physician Assistant 1717 N E St, Suite 208, Pensacola, FL 32501-6339 2015-12-17
1538532692 Kaley Morris Physician Assistant 4724 N Davis Hwy, Pensacola, FL 32503 2015-11-10
1841607678 Brian Scott Lang Physician Assistant 1717 N E St Ste 205, Pensacola, FL 32501-6336 2014-07-14
1013337435 Kelly Demuynck Physician Assistant 4012 N 9th Ave, Pensacola, FL 32503-2824 2014-04-24
1417290586 Jaclyn M Nietzer Physician Assistant 5151 N 9th Ave, Ste 200, Pensacola, FL 32504-8721 2013-03-27
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Competitor

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City PENSACOLA
Zip Code 32501

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Dataset Information

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.

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