Provider Demographics
NPI:1538107115
Name:PYRAM-BERNARD, NANCY (DO)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:PYRAM-BERNARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14880 SW 45TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3333
Mailing Address - Country:US
Mailing Address - Phone:954-699-4929
Mailing Address - Fax:954-437-9428
Practice Address - Street 1:6971 W SUNRISE BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-4407
Practice Address - Country:US
Practice Address - Phone:954-791-0711
Practice Address - Fax:954-791-4392
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8261207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH42102Medicare UPIN
FLE5819Medicare ID - Type Unspecified