Provider Demographics
NPI:1972604775
Name:GINSBERG, BERNARD PAUL (MD)
Entity type:Individual
Prefix:
First Name:BERNARD
Middle Name:PAUL
Last Name:GINSBERG
Suffix:
Gender:M
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 423
Mailing Address - Street 2:
Mailing Address - City:TAVERNIER
Mailing Address - State:FL
Mailing Address - Zip Code:33070-0423
Mailing Address - Country:US
Mailing Address - Phone:305-852-9300
Mailing Address - Fax:
Practice Address - Street 1:91555 OVERSEAS HWY
Practice Address - Street 2:SUITE 3
Practice Address - City:TAVERNIER
Practice Address - State:FL
Practice Address - Zip Code:33070-2505
Practice Address - Country:US
Practice Address - Phone:305-852-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME84661207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME84661OtherTAX ID