| Brunette Bastien Medical Services Llc | |
|
1425 Viscaya Pkwy Ste 101 Cape Coral FL 33990-3294 | |
| (239) 293-5829 | |
| (239) 236-1200 |
| Full Name | Brunette Bastien Medical Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1425 Viscaya Pkwy Ste 101, Cape Coral, Florida |
| Authorized Official Name and Position | Brunette Bastien (OWNER) |
| Authorized Official Contact | 2399194851 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brunette Bastien Medical Services Llc 1425 Viscaya Pkwy Ste 101 Cape Coral FL 33990-3294 Ph: (239) 919-4851 | Brunette Bastien Medical Services Llc 1425 Viscaya Pkwy Ste 101 Cape Coral FL 33990-3294 Ph: (239) 293-5829 |
| NPI Number | 1114652476 |
|---|---|
| Provider Enumeration Date | 07/20/2022 |
| Last Update Date | 02/01/2023 |
| Certification Date | 02/01/2023 |
| Medicare PECOS PAC ID | 3476938515 |
|---|---|
| Medicare Enrollment ID | O20220909002804 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114652476 | NPI | - | NPPES |
| Provider Name | Brunette Bastien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699150953 PECOS PAC ID: 6800198334 Enrollment ID: I20151230000949 |
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