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NPI Code Detail

MEDICARE: DR. BRYANT LE VUONG D.O.

MEDICARE: DR. BRYANT LE VUONG D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation PhysicianOS10728FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598905754
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRYANT LE VUONG D.O.
Provider Business Mailing Address
First Line : 12290 CANAL GRANDE DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-9495
Country : US
Telephone Number : 305-204-6595
Fax Number :
Provider Business Practice Location Address
First Line : 2776 CLEVELAND AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-5855
Country : US
Telephone Number : 239-343-2686
Fax Number : 239-343-2669
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2009
Last Update Date : 07/02/2025

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Directions to “ DR. BRYANT LE VUONG D.O.” Practice Location

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