Provider Demographics
NPI:1437122900
Name:BERMUDEZ, YANIRA M (DPM)
Entity Type:Individual
Prefix:DR
First Name:YANIRA
Middle Name:M
Last Name:BERMUDEZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 W ATLANTIC AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8174
Mailing Address - Country:US
Mailing Address - Phone:561-284-8323
Mailing Address - Fax:561-284-8324
Practice Address - Street 1:5353 W ATLANTIC AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8174
Practice Address - Country:US
Practice Address - Phone:561-284-8323
Practice Address - Fax:561-284-8324
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2851213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65760OtherBCBS
FL340325400Medicaid
FL65760OtherBCBS
FL65760YMedicare PIN
FL340325400Medicaid