Provider Demographics
NPI:1821685330
Name:BERNIER NEUROPSYCHOLOGY LLC
Entity Type:Organization
Organization Name:BERNIER NEUROPSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:VIVIANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FIGUEROA BERNIER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:727-332-9535
Mailing Address - Street 1:29605 US HIGHWAY 19 N STE 310
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-1540
Mailing Address - Country:US
Mailing Address - Phone:727-332-9535
Mailing Address - Fax:
Practice Address - Street 1:29605 US HIGHWAY 19 N STE 310
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1540
Practice Address - Country:US
Practice Address - Phone:727-332-9535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101347800Medicaid