Provider Demographics
NPI:1952056194
Name:BERNING, MAUREEN (LM, CMP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:BERNING
Suffix:
Gender:F
Credentials:LM, CMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 W PAXTON AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-5616
Mailing Address - Country:US
Mailing Address - Phone:813-468-0021
Mailing Address - Fax:
Practice Address - Street 1:215 LITHIA PINECREAST RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:813-685-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW403176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty