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General NPI Number Information
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NPI Number | 1932114477
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Entity Type | Individual
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Provider Name | BERNIE KAIMAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 6100 MINTON RD SUITE 102
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City | PALM BAY
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State | FL
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Zip | 32907
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Country | US
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Telephone | 321-724-1171
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Fax | 321-724-9024
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Provider Business Mailing Address
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Address Line | 95 BULLDOG BLVD SUITE 202
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City | MELBOURNE
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State | FL
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Zip | 32901-3332
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Country | US
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Telephone | 321-727-2990
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Fax | 321-724-0455
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2352
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License Number State | FL
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