MEDICARE: JENNIFER MARIE BERNDT APRN

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	363LW0102X	Women's Health Nurse Practitioner	APRN11017830	FL
2	363LF0000X	Family Nurse Practitioner	APRN11017830	FL

General Provider Information

NPI Number	:	1487307302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MARIE BERNDT APRN

Provider Business Mailing Address
First Line	:	PO BOX 748817
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-8817
Country	:	US
Telephone Number	:	813-286-0033
Fax Number	:	813-282-1806

Provider Business Practice Location Address
First Line	:	515 S KINGS AVE STE 3100
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-6060
Country	:	US
Telephone Number	:	813-681-9171
Fax Number	:	813-681-7580

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

Provider Enumeration Date	:	01/31/2022
Last Update Date	:	03/16/2026

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