Provider Demographics
NPI:1932147527
Name:NANCY PYRAM-BERNARD DO PA
Entity type:Organization
Organization Name:NANCY PYRAM-BERNARD DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PYRAM-BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-699-4929
Mailing Address - Street 1:14880 SW 45TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3333
Mailing Address - Country:US
Mailing Address - Phone:954-699-4929
Mailing Address - Fax:954-437-9428
Practice Address - Street 1:14880 SW 45TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3333
Practice Address - Country:US
Practice Address - Phone:954-699-4929
Practice Address - Fax:954-437-9428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8261207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE5819Medicare ID - Type Unspecified
FLH42102Medicare UPIN