Healthcare Provider Details

I. General information

NPI: 1306548466
Provider Name (Legal Business Name): ADRIANA BERMEJO SARMIENTO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 LEE BLVD FL 1
LEHIGH ACRES FL
33971-1576
US

IV. Provider business mailing address

PO BOX 1588
FORT MYERS FL
33902-1588
US

V. Phone/Fax

Practice location:
  • Phone: 239-278-3600
  • Fax:
Mailing address:
  • Phone: 239-278-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME180525
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: