Healthcare Provider Details

I. General information

NPI: 1922078062
Provider Name (Legal Business Name): BRET D KUEBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 PARK AVE
BOCA GRANDE FL
33921-0517
US

IV. Provider business mailing address

PO BOX 517
BOCA GRANDE FL
33921-0517
US

V. Phone/Fax

Practice location:
  • Phone: 941-964-2276
  • Fax: 941-964-2983
Mailing address:
  • Phone: 941-964-2276
  • Fax: 941-964-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01061176A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: