MEDICARE: PAUL BERNSTEIN DO

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208100000X	Physical Medicine & Rehabilitation Physician	OS20017	FL
3	208D00000X	General Practice Physician	OS021606	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003479221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL BERNSTEIN DO

Provider Business Mailing Address
First Line	:	903 SW 27TH TER
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7913
Country	:	US
Telephone Number	:	646-417-2396
Fax Number	:

Provider Business Practice Location Address
First Line	:	9719 LANTANA RD
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6143
Country	:	US
Telephone Number	:	646-417-2396
Fax Number	:

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

Provider Enumeration Date	:	04/15/2019
Last Update Date	:	03/23/2026

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