MEDICARE: SYDNI BERNINGER

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	235Z00000X	Speech-Language Pathologist	SA18938	FL

General Provider Information

NPI Number	:	1407555113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNI BERNINGER

Provider Business Mailing Address
First Line	:	11039 SHADY LAKE RUN
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-9631
Country	:	US
Telephone Number	:	815-355-3603
Fax Number	:

Provider Business Practice Location Address
First Line	:	11039 SHADY LAKE RUN
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33913-9631
Country	:	US
Telephone Number	:	815-355-3603
Fax Number	:

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

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	03/01/2023

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Directions to “ SYDNI BERNINGER ” Practice Location

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