MEDICARE: INAYMIS E BERNAL MT

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1962775627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INAYMIS E BERNAL MT

Provider Business Mailing Address
First Line	:	5406 HOOVER BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-3201
Country	:	US
Telephone Number	:	813-880-7577
Fax Number	:

Provider Business Practice Location Address
First Line	:	5406 HOOVER BLVD
Second Line	:	SUITE 18
City	:	TAMPA
State	:	FL
Zip	:	33634-5330
Country	:	US
Telephone Number	:	813-880-7577
Fax Number	:	813-880-7553

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

Provider Enumeration Date	:	02/10/2012
Last Update Date	:	09/06/2012

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Directions to “ INAYMIS E BERNAL MT” Practice Location

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