Healthcare Provider Details

I. General information

NPI: 1982523668
Provider Name (Legal Business Name): JOANALLY T. BERNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 E GRANADA BLVD STE A-1
ORMOND BEACH FL
32176-6627
US

IV. Provider business mailing address

194 E GRANADA BLVD STE A-1
ORMOND BEACH FL
32176-6627
US

V. Phone/Fax

Practice location:
  • Phone: 386-299-4519
  • Fax:
Mailing address:
  • Phone: 386-299-4519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA24060
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: