Individual
DON BERNARD DESTEPHANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 SHIRCLIFF WAY, DEPT OF PATHOLOGY, JACKSONVILLE, FL 32204-4748
(904) 308-3803
(904) 308-2970
Mailing address
PO BOX 144333, ORLANDO, FL 32814-4333
(407) 422-9831
(407) 206-1767
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME53628
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064755100
—
FL
Enumeration date
01/04/2007
Last updated
10/09/2018
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