Provider Demographics
NPI:1952319006
Name:BERNSTEIN, PAULA ELIZABETH (CRNFA)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ELIZABETH
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:MISS
Other - First Name:PAULA
Other - Middle Name:ELIZABETH
Other - Last Name:MATTIOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 21686
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-1686
Mailing Address - Country:US
Mailing Address - Phone:813-343-5500
Mailing Address - Fax:813-343-5506
Practice Address - Street 1:12880 COMMODITY PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-3101
Practice Address - Country:US
Practice Address - Phone:813-343-5500
Practice Address - Fax:813-343-5506
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2727472163W00000X, 163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL311699900Medicaid