Individual
JACQUELINE MAHER BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1673 MASON AVE, SUITE 305, DAYTONA BEACH, FL 32117-5515
(386) 274-7118
Mailing address
1673 MASON AVE, SUITE 305, DAYTONA BEACH, FL 32117-5516
(386) 274-7118
(386) 274-6173
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME 103282
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME103282
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018433800
—
FL
01
—
6G4SN
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
01/30/2006
Last updated
06/05/2025
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