Healthcare Provider Details

I. General information

NPI: 1528553179
Provider Name (Legal Business Name): KRISTI BERNARDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 NE 119TH ST
MIAMI FL
33161-5375
US

IV. Provider business mailing address

1620 SW 55TH AVE
PLANTATION FL
33317-5926
US

V. Phone/Fax

Practice location:
  • Phone: 305-754-2229
  • Fax:
Mailing address:
  • Phone: 904-742-5010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP3298192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: