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General NPI Number Information
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NPI Number | 1801827761
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Entity Type | Organization
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Legal Business Name | MARK BERNHARDT, MD, PA
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 01/17/2012
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Provider Practice Location Address
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Address Line | 1601 E BROWARD BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2160
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Country | US
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Telephone | 954-463-3421
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Fax | 954-463-3316
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Provider Business Mailing Address
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Address Line | 1601 E BROWARD BLVD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-2160
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Country | US
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Telephone | 954-463-3421
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Fax | 954-463-3316
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK BERNHARDT
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Credential | M.D.
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Telephone | 954-463-3421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 57531
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License Number State | FL
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