Provider Demographics
NPI:1144872425
Name:BERNAL RIERA, MARIA JOSE (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JOSE
Last Name:BERNAL RIERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14260 W NEWBERRY RD # N232
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-2765
Mailing Address - Country:US
Mailing Address - Phone:727-609-5610
Mailing Address - Fax:727-265-3007
Practice Address - Street 1:7901 4TH ST N STE 18181
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-4305
Practice Address - Country:US
Practice Address - Phone:727-609-5610
Practice Address - Fax:727-265-3007
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME165554207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism