Individual
MRS. BETHANY LYNN BERGHOFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
2863 ALT 19, PALM HARBOR, FL 34683-1926
(272) 781-5652
(727) 786-5416
Mailing address
2863 ALT 19, PALM HARBOR, FL 34683-1926
(727) 781-5652
(727) 786-5416
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0110001819
VA
363AM0700X
Medical Physician Assistant
Primary
PA9104980
FL
Other
Enumeration date
03/07/2006
Last updated
03/17/2018
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