Provider Demographics
NPI:1205917465
Name:BERNATSKY, SYLVIA (OD)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:
Last Name:BERNATSKY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3626
Mailing Address - Country:US
Mailing Address - Phone:813-254-1962
Mailing Address - Fax:813-251-6981
Practice Address - Street 1:655 BRANDON TOWN CENTER MALL
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4770
Practice Address - Country:US
Practice Address - Phone:813-681-1036
Practice Address - Fax:813-651-0718
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC002018152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20191VMedicare ID - Type Unspecified