Healthcare Provider Details

I. General information

NPI: 1336085646
Provider Name (Legal Business Name): BIANCA BERNARDO OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BIANCA MERCADO

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3278 CANOE CREEK RD
SAINT CLOUD FL
34772-9115
US

IV. Provider business mailing address

2682 ELLIPSE LN APT 309
ORLANDO FL
32837-6010
US

V. Phone/Fax

Practice location:
  • Phone: 321-837-9737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number26051
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: