MEDICARE: DAVID BERNSTEIN

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	390200000X	Student in an Organized Health Care Education/Training Program
2	363A00000X	Physician Assistant	9120356	FL

General Provider Information

NPI Number	:	1356039630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BERNSTEIN

Provider Business Mailing Address
First Line	:	2628 REAGAN TRL
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1811
Country	:	US
Telephone Number	:	407-739-8320
Fax Number	:

Provider Business Practice Location Address
First Line	:	8315 RED BUG LAKE RD
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6860
Country	:	US
Telephone Number	:	407-739-8320
Fax Number	:

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

Provider Enumeration Date	:	04/25/2023
Last Update Date	:	07/25/2025

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Directions to “ DAVID BERNSTEIN ” Practice Location

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