MEDICARE: DR. CYNTHIA P BERNAL M.D.

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	207V00000X	Obstetrics & Gynecology Physician	ME138357	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366766800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA P BERNAL M.D.

Provider Business Mailing Address
First Line	:	1135 E STATE ROAD 434 STE 1001
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2744
Country	:	US
Telephone Number	:	407-635-3220
Fax Number	:	407-636-7841

Provider Business Practice Location Address
First Line	:	1135 E STATE ROAD 434
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2746
Country	:	US
Telephone Number	:	407-635-3220
Fax Number	:	407-636-7841

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

Provider Enumeration Date	:	03/25/2010
Last Update Date	:	05/07/2019

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