Provider Demographics
NPI:1801839410
Name:BERTRAND, PAUL E (RN)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:E
Last Name:BERTRAND
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 S OLIVE AVE
Mailing Address - Street 2:#218
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6120
Mailing Address - Country:US
Mailing Address - Phone:305-742-6099
Mailing Address - Fax:
Practice Address - Street 1:801 S OLIVE AVE
Practice Address - Street 2:#218
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6120
Practice Address - Country:US
Practice Address - Phone:305-742-6099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10016005367500000X
VI9853367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered