Provider Demographics
NPI:1912983776
Name:BERNSTEIN, PATRICIA (ARNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18650 GULF BLVD
Mailing Address - Street 2:APT. 501
Mailing Address - City:INDIAN SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33785-2058
Mailing Address - Country:US
Mailing Address - Phone:727-517-9412
Mailing Address - Fax:
Practice Address - Street 1:7601 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4862
Practice Address - Country:US
Practice Address - Phone:727-394-8442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9178222363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP84158Medicare UPIN
FLU0364AMedicare ID - Type Unspecified