Provider Demographics
NPI:1750379798
Name:HAROLD N BERNSTEIN, DPM,PA
Entity type:Organization
Organization Name:HAROLD N BERNSTEIN, DPM,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PODIATRIC MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-522-3633
Mailing Address - Street 1:5411 16TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-2003
Mailing Address - Country:US
Mailing Address - Phone:727-522-3633
Mailing Address - Fax:727-528-4880
Practice Address - Street 1:5411 16TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-2003
Practice Address - Country:US
Practice Address - Phone:727-522-3633
Practice Address - Fax:727-528-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-621213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0099655OtherGROUP HEALTH INC (GHI)
FL87291OtherBLUE SHIELD OF FLORIDA
FL27-00264OtherEVERCARE
FL0099655OtherGROUP HEALTH INC (GHI)
FL27-00264OtherEVERCARE