| Doctor Name: | JEAN BERNANOS B EDMOND |
| NPI Number: | 1972917771 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 18834 |
| Business Practice Address: | 1221 71st St Miami Beach, FL - 331413647 |
| Business Phone Number: | 3055388835 |
| Business Fax Number: | 3059384044 |
| Mailing Address: | 1221 71st St, MIAMI BEACH |
| State: | FL |
| Postal Code: | 331413647 |
| Phone Number: | 3055388835 |
| Fax Number: | 3059384044 |
| NPI Enumeration Date: | 06/19/2014 |
| NPI Last Update Date: | 03/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 18834 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |