NPI 1053806000 · live from the CMS NPI Registry
Bernice Baroudi, DO
Dermatology in Port Charlotte, FL. National Provider Identifier 1053806000, active.
NPI record
| NPI | 1053806000 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 3222 Tamiami Trl, Port Charlotte, FL 33952 |
| Practice phone | 941-627-5155 |
| Enumerated | June 22, 2018 |
| Last updated | December 15, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology primary | 207N00000X | OS19199 (FL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.