MEDICARE: PAUL R. BRETTON MD

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
1	208800000X	Urology Physician	ME0057549	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	243136	OTHER	FL	AVMED PROVIDER NUMBER
2	739834	OTHER	FL	FIRST HLTH/CCN PROVIDER #
3	1192948	OTHER	FL	WELLCARE
4	4199976	OTHER	FL	AETNA PROVIDER NUMBER
5	0627067-005	OTHER	FL	CIGNA PROVIDER NUMBER
6	215252	OTHER	FL	AMERIGROUP PROVIDER NUM.
7	ME0057549	OTHER	FL	METCARE PROVIDER NUMBER
8	10507	OTHER	FL	BCBS PROVIDER NUMBER
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	285158	OTHER	FL	USA MNGD. CR. PROVIDER #
11	77074	OTHER	FL	OP. ENGIN. PROVIDER #

General Provider Information

NPI Number	:	1649245036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL R. BRETTON MD

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-424-2030
Fax Number	:	239-343-4116

Provider Business Practice Location Address
First Line	:	507 DEL PRADO BLVD S
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-2618
Country	:	US
Telephone Number	:	239-772-0500
Fax Number	:	239-772-3076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	03/24/2021

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Directions to “ PAUL R. BRETTON MD” Practice Location

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