Provider Demographics
NPI:1629338918
Name:BERNABE, OFELIA MADRID (MD)
Entity Type:Individual
Prefix:DR
First Name:OFELIA
Middle Name:MADRID
Last Name:BERNABE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7066 TWIN HILLS TER
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-2401
Mailing Address - Country:US
Mailing Address - Phone:941-907-8294
Mailing Address - Fax:941-907-8284
Practice Address - Street 1:7066 TWIN HILLS TER
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-2401
Practice Address - Country:US
Practice Address - Phone:941-907-8294
Practice Address - Fax:941-907-8284
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO33055207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine