Individual
MRS. BERNICE DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MSN, APNC
Contact information
Practice address
1805 HOBBS ROAD, AUBURNDALE, FL 33823-4644
(863) 965-5400
(863) 965-3739
Mailing address
1290 GOLFVIEW AVE, ATTN: ACCOUNTS RECEIVABLE, BARTOW, FL 33830-6740
(863) 519-7900
(863) 519-7696
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
26NN03620400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004304900
—
FL
Enumeration date
08/18/2006
Last updated
05/09/2012
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