Healthcare Provider Details

I. General information

NPI: 1427617976
Provider Name (Legal Business Name): GINA MICHELE BERNER MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 S PINELLAS AVE
TARPON SPRINGS FL
34689-1946
US

IV. Provider business mailing address

1185 S PINELLAS AVE APT 1406
TARPON SPRINGS FL
34689-3763
US

V. Phone/Fax

Practice location:
  • Phone: 727-934-1000
  • Fax:
Mailing address:
  • Phone: 727-275-3229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: