Provider Demographics
NPI:1821284134
Name:FOSTER, BERNICE G (ARNP)
Entity Type:Individual
Prefix:
First Name:BERNICE
Middle Name:G
Last Name:FOSTER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 N. DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146
Mailing Address - Country:US
Mailing Address - Phone:954-965-4900
Mailing Address - Fax:786-272-5719
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:SUITE 605
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-965-4900
Practice Address - Fax:954-515-1203
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2201912364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP94695Medicare UPIN