Bernardo, George Thomas

Bernardo, George Thomas is an individual health care provider with primary practice located at 790 Dunlawton Ave Suite E, Port Orange FL 32127-9279. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bernardo, George Thomas can be contacted via phone (386) 760-1877.

Contact Information

Primary practice address
790 Dunlawton Ave Suite E Port Orange FL 32127-9279
Phone: (386) 760-1877
Fax: (386) 760-2791
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME0056972 Florida

Profile Details

NPI number 1124129259
LBN Legal business name Bernardo, George Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Oct 26th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124129259 NPPES
Florida Other 45360 MEDICARE GROUP
Florida Other 0551243 MEDICARE GROUP
Florida MEDICAID 051717800 MEDICARE GROUP
Florida Other 080164320 MEDICARE GROUP
Florida Other 59-3667262 MEDICARE GROUP

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