Provider Demographics
NPI:1699759878
Name:BERNENE, JAMES LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LOUIS
Last Name:BERNENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 9TH ST N STE 110
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5886
Mailing Address - Country:US
Mailing Address - Phone:239-624-0940
Mailing Address - Fax:239-624-0941
Practice Address - Street 1:311 9TH ST N STE 110
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5886
Practice Address - Country:US
Practice Address - Phone:239-624-0940
Practice Address - Fax:239-624-0941
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127142207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14E60OtherBCBS
FL018418800Medicaid
FL14E60OtherBCBS
FL14E60OtherBCBS
FLIR396ZMedicare PIN