MEDICARE: JOHN P BERNOT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2016-01284	NC
2	207Q00000X	Family Medicine Physician	ME129034	FL

General Provider Information

NPI Number	:	1003250481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN P BERNOT MD

Provider Business Mailing Address
First Line	:	2101 CENTRE PARK WEST DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6453
Country	:	US
Telephone Number	:	561-242-3009
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 CENTRE PARK WEST DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6453
Country	:	US
Telephone Number	:	561-242-3009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2013
Last Update Date	:	07/09/2023

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