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General NPI Number Information
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NPI Number | 1114904299
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Entity Type | Individual
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Provider Name | BRICE TOMPKINS MD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 24600 S TAMIAMI TRAIL SUITE 500
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-7025
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Country | US
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Telephone | 239-948-3761
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Fax | 239-948-3762
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Provider Business Mailing Address
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Address Line | 2675 WINKLER AVE FL 2
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City | FORT MYERS
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State | FL
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Zip | 33901-9342
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Country | US
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Telephone | 877-856-3774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME93752
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License Number State | FL
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