Individual
RICKY BERNARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3501 CORTEZ RD W, POD #2, BRADENTON, FL 34210-3104
(941) 757-6300
(941) 757-8877
Mailing address
951 BROKEN SOUND PKWY NW, BOCA RATON, FL 33487-3507
(561) 241-9300
(561) 372-0214
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT20720
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT20720
STATE LICENSE
FL
Enumeration date
08/25/2006
Last updated
07/08/2007
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