Provider Demographics
NPI:1356131742
Name:BERNSTEIN, SUMMER MICHELLE
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:MICHELLE
Last Name:BERNSTEIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5640 COACH HOUSE CIR APT E
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-8603
Mailing Address - Country:US
Mailing Address - Phone:786-282-9677
Mailing Address - Fax:
Practice Address - Street 1:305 WAYMONT CT STE 101
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3566
Practice Address - Country:US
Practice Address - Phone:954-850-1920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician