| Doctor Name: | MR. BERNARD PHILIPPE |
| NPI Number: | 1548648561 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | ACN720 |
| Business Practice Address: | 1839 Central Ave St Petersburg, FL - 33713 |
| Business Phone Number: | 7273221054 |
| Business Fax Number: | 7278228081 |
| Mailing Address: | 1839 Central Ave, ST PETERSBURG |
| State: | FL |
| Postal Code: | 33713 |
| Phone Number: | 7273221054 |
| Fax Number: | 7278228081 |
| NPI Enumeration Date: | 05/11/2015 |
| NPI Last Update Date: | 12/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ACN720 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |