Healthcare Provider Details

I. General information

NPI: 1588702419
Provider Name (Legal Business Name): JAMES BRIAN THORNBURG D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5435 PARK CENTRAL CT
NAPLES FL
34109-6002
US

IV. Provider business mailing address

5435 PARK CENTRAL CT
NAPLES FL
34109-6002
US

V. Phone/Fax

Practice location:
  • Phone: 239-348-7337
  • Fax: 239-348-7391
Mailing address:
  • Phone: 239-348-7337
  • Fax: 239-348-7391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS9029
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: