Provider Demographics
NPI:1609937069
Name:YUKNA, BERNARD JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:JOHN
Last Name:YUKNA
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 1:7901 4TH STREET NORTH
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ST.PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702
Mailing Address - Country:US
Mailing Address - Phone:410-638-7916
Mailing Address - Fax:410-638-7916
Practice Address - Street 1:7901 4TH STREET NORTH
Practice Address - Street 2:SUITE 205
Practice Address - City:ST.PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702
Practice Address - Country:US
Practice Address - Phone:727-209-5470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014206207QA0505X
FLME100933207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB67672Medicare UPIN