Provider Demographics
NPI:1598759474
Name:BERNS, ALAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:S
Last Name:BERNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3272 W LAKE MARY BLVD
Mailing Address - Street 2:SUITE 1820
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3589
Mailing Address - Country:US
Mailing Address - Phone:407-330-7393
Mailing Address - Fax:407-330-7356
Practice Address - Street 1:3272 W LAKE MARY BLVD
Practice Address - Street 2:SUITE 1820
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3589
Practice Address - Country:US
Practice Address - Phone:407-330-7393
Practice Address - Fax:407-330-7356
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME588902084P0800X, 2084F0202X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11882UMedicare ID - Type Unspecified
E15591Medicare UPIN