Provider Demographics
NPI:1851117253
Name:BERNARD, CHRISTLEY F
Entity type:Individual
Prefix:
First Name:CHRISTLEY
Middle Name:F
Last Name:BERNARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 20TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3541
Mailing Address - Country:US
Mailing Address - Phone:239-595-9992
Mailing Address - Fax:
Practice Address - Street 1:3360 20TH AVE NE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-3541
Practice Address - Country:US
Practice Address - Phone:239-595-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL018573171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter