Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | ME0077146 | FL |
NPI | 1114915949 |
---|---|
Provider Name | Adam B Bernstein |
First Address | Orlando, FL 32886-2103 |
Second Address | Boca Raton, FL 33486-2304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G63568 | (02) |