Lopez Ortiz, Bryan R

Lopez Ortiz, Bryan R is an individual health care provider with primary practice located at 708 Del Prado Blvd S Ste 9 , Cape Coral FL 33990-2633. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Lopez Ortiz, Bryan R can be contacted via phone (239) 424-2440.

Contact Information

Primary practice address
708 Del Prado Blvd S Ste 9 Cape Coral FL 33990-2633
Phone: (239) 424-2440
Fax: (239) 343-4258
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9118453 Florida

Profile Details

NPI number 1326817388
LBN Legal business name Lopez Ortiz, Bryan R
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 1st, 2024
Last updated Mar 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326817388 NPPES
Florida MEDICAID 121313000

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