Healthcare Provider Details

I. General information

NPI: 1699759878
Provider Name (Legal Business Name): JAMES LOUIS BERNENE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 07/21/2022
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 9TH ST N STE 110
NAPLES FL
34102-5886
US

IV. Provider business mailing address

311 9TH ST N STE 110
NAPLES FL
34102-5886
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-0940
  • Fax: 239-624-0941
Mailing address:
  • Phone: 239-624-0940
  • Fax: 239-624-0941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberME127142
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: