Provider Demographics
NPI:1003201468
Name:BERMUDEZ, AIMEE
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:BERMUDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 7TH ST N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5754
Mailing Address - Country:US
Mailing Address - Phone:239-624-3997
Mailing Address - Fax:239-624-8101
Practice Address - Street 1:350 7TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5754
Practice Address - Country:US
Practice Address - Phone:239-624-3997
Practice Address - Fax:239-624-8101
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9310332363LF0000X
FLARNP9310332363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP967775OtherOPTIMUM
FLIF216ZOtherMEDICARE (BROWARD COUNTY)
FLY0RU8OtherBCBS FL
FL016751300Medicaid
FLIF216WOtherMEDICARE
FLP01503327OtherRAILROAD MEDICARE
FLIF216YOtherMEDICARE (DADE COUNTY)
FL1042040OtherCIGNA
FL4544599OtherAETNA
FLP103118OtherFREEDOM