Provider Demographics
NPI:1881679546
Name:BERNDES, HANS ALLEN (MD)
Entity type:Individual
Prefix:
First Name:HANS
Middle Name:ALLEN
Last Name:BERNDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7955 SPYGLASS HILL RD STE A
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8249
Mailing Address - Country:US
Mailing Address - Phone:321-255-6670
Mailing Address - Fax:321-775-1364
Practice Address - Street 1:7955 SPYGLASS HILL RD STE B
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-8249
Practice Address - Country:US
Practice Address - Phone:321-255-6670
Practice Address - Fax:321-242-2545
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138288207L00000X
NV8561207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1881679546Medicaid
FL27867OtherBCBS
NE002002605Medicaid
OH10194100001OtherOHIO WC
NVG61695Medicare UPIN