Individual
BERNY EXCELLENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1839 CENTRAL AVE, SAINT PETERSBURG, FL 33713-8900
(727) 322-1054
(727) 483-5441
Mailing address
1839 CENTRAL AVE, ST PETERSBURG, FL 33713-8900
(727) 322-1054
(727) 322-2725
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
ME0058124
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053002600
—
FL
Enumeration date
10/13/2006
Last updated
04/30/2013
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