Provider Demographics
NPI:1659248466
Name:BERNARD, CHRISTIAN (RD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:BERNARD
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1059 NE 133RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4216
Mailing Address - Country:US
Mailing Address - Phone:617-909-5843
Mailing Address - Fax:
Practice Address - Street 1:1059 NE 133RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-4216
Practice Address - Country:US
Practice Address - Phone:617-909-5843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND11923133V00000X
KY299485133V00000X
GALD007833133V00000X
IL164.023016133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered