Provider Demographics
NPI:1982117495
Name:BERNAL, GILBERT (BS)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:
Last Name:BERNAL
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 SW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1719
Mailing Address - Country:US
Mailing Address - Phone:305-305-4907
Mailing Address - Fax:
Practice Address - Street 1:3400 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-1719
Practice Address - Country:US
Practice Address - Phone:305-305-4907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator