Provider Demographics
NPI:1255373791
Name:BERNOT, LIANA (MD)
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:BERNOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 565417
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-5417
Mailing Address - Country:US
Mailing Address - Phone:786-216-6211
Mailing Address - Fax:305-443-7003
Practice Address - Street 1:5200 SW 8TH STREET
Practice Address - Street 2:SUITE 204 A
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-443-2333
Practice Address - Fax:305-443-7003
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92939207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35048OtherBCBS
FL274474100Medicaid
I49373Medicare UPIN
FL274474100Medicaid