Basic Information
| Provider Information | |||||||||
| NPI: | 1699759878 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERNENE | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | LOUIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 311 9TH ST N STE 110 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341025886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2396240940 | ||||||||
| FaxNumber: | 2396240941 | ||||||||
| Practice Location | |||||||||
| Address1: | 311 9TH ST N STE 110 | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 341025886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2396240940 | ||||||||
| FaxNumber: | 2396240941 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | ME127142 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 14E60 | 01 | FL | BCBS | OTHER | 018418800 | 05 | FL | MEDICAID |