Bernard Thomas Despres, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OS0005626 Issued in FL

Practice address

1925 Mizell Ave
Ste 104
Winter Park, FL 32792

Phone

(407) 657-4407

Fax

(407) 657-4669

NPI assigned

Feb 28, 2006

Last updated

Aug 31, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aloma Park OB/GYN PA

  • Obstetrics & Gynecology Physician
  • Winter Park, FL
  • NPI 1952375388
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1356317283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE",
            "address_2": "STE 104",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-657-4407",
            "fax_number": "407-657-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 MIZELL AVE",
            "address_2": "STE 104",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-657-4407",
            "fax_number": "407-657-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPRES",
        "first_name": "BERNARD",
        "middle_name": "THOMAS",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS0005626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052247300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Rae Derequito
• Mukesh D Desai, RPH
• Pratik Desai, M.D.
• Alexia Deshommes, PT
• Vanessa Desinor
• Pierre L Desrosiers, MSW
• Santano Dessin, RBT
• Alvin Tracey Detorres, M.D.
• Devereux
• Devereux Foundation

• Obstetrics & Gynecology Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.