Provider Demographics
NPI:1215043898
Name:BERNAL, TATIANA I (RN)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:I
Last Name:BERNAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12032 SW 132ND CT
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6409
Mailing Address - Country:US
Mailing Address - Phone:305-255-7700
Mailing Address - Fax:
Practice Address - Street 1:12032 SW 132ND CT
Practice Address - Street 2:SUITE 204
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6409
Practice Address - Country:US
Practice Address - Phone:305-255-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1896132163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN1896132OtherLICENSE NUMBER