Doctor Name: | SUSAN F BERNAL |
NPI Number: | 1790795565 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | |
Business Practice Address: | 1310 N Church Ave Mulberry, FL - 338602047 |
Business Phone Number: | 8634259309 |
Business Fax Number: | 8634258401 |
Mailing Address: | Po Box 1312, MULBERRY |
State: | FL |
Postal Code: | 338601312 |
Phone Number: | 8634259309 |
Fax Number: | 8634258401 |
NPI Enumeration Date: | 08/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |