Susan F Bernal, ARNP

Individual provider Active NPI Family Nurse Practitioner · Mulberry, FL

NPI 1790795565 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1790795565
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
Practice address
1310 N Church Ave
Mulberry, FL 33860-2047
Phone
(863) 425-9309
Fax
(863) 425-8401
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
016828622FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health Past
since Oct 1, 2000
Accepting new patients
Florida Department of Health Past Accepting new patients
Salazar Family Health Care, Inc Past
since Aug 15, 2003
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X FL Yes

Addresses

Primary practice location

1310 N Church Ave
Mulberry, FL 33860-2047

Mailing address

PO Box 1312
Mulberry, FL 33860-1312
Phone (863) 425-9309

Other providers in Mulberry, FL

All providers in Mulberry, FL · Family Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.