Provider Demographics
NPI:1063466183
Name:BERNIER, JAYNE M (MD)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:M
Last Name:BERNIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1106 DRUID RD S STE 302
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3841
Mailing Address - Country:US
Mailing Address - Phone:727-441-3711
Mailing Address - Fax:727-441-3716
Practice Address - Street 1:300 PINELLAS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3804
Practice Address - Country:US
Practice Address - Phone:727-441-3711
Practice Address - Fax:864-987-1611
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME743362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY78K982Medicare ID - Type Unspecified