MEDICARE: DANIEL BERMUDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156F00000X	Technician/Technologist

General Provider Information

NPI Number	:	1023858206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL BERMUDEZ

Provider Business Mailing Address
First Line	:	4220 SW 67TH TER
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-6424
Country	:	US
Telephone Number	:	786-223-2543
Fax Number	:

Provider Business Practice Location Address
First Line	:	4220 SW 67TH TER
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-6424
Country	:	US
Telephone Number	:	786-223-2543
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	05/28/2024

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Directions to “ DANIEL BERMUDEZ ” Practice Location

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