Healthcare Provider Details
I. General information
NPI: 1427004589
Provider Name (Legal Business Name): MARIA HELENA BERNARDO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 05/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 AVE WINSTON CHURCHILL PMB 108
SAN JUAN PR
00926-6013
US
IV. Provider business mailing address
130 AVE WINSTON CHURCHILL PMB 108
SAN JUAN PR
00926-6013
US
V. Phone/Fax
- Phone: 787-755-0595
- Fax:
- Phone: 787-755-0595
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 11401 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: