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NPI 1467060434

NPI 1467060434 : REBECCA BERTONE APRN : PONTE VEDRA, FL

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General NPI Number Information
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    NPI Number           |    1467060434
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA BERTONE APRN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/16/2020
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    Last Update Date     |    06/27/2025
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Provider Practice Location Address
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    Address Line         |    90 FORT WADE ROAD SUITE 100 #1072
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    City                 |    PONTE VEDRA
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    State                |    FL
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    Zip                  |    32081
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    Country              |    US
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    Telephone            |    904-772-5689
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    90 FORT WADE ROAD SUITE 100 #1072
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    City                 |    PONTE VEDRA
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    State                |    FL
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    Zip                  |    32081
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    Country              |    US
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    Telephone            |    904-772-5689
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    APRN11008074
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    License Number State |    FL
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