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NPI Code Detail

MEDICARE: ANNIET BERNAL SOSA

MEDICARE: ANNIET BERNAL SOSA
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
1363A00000XPhysician AssistantFL

General Provider Information

NPI Number : 1093665242
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNIET BERNAL SOSA
Provider Business Mailing Address
First Line : 721 NW JUANITA CT
Second Line :
City : CAPE CORAL
State : FL
Zip : 33993-1807
Country : US
Telephone Number : 239-440-3361
Fax Number :
Provider Business Practice Location Address
First Line : 9981 S HEALTHPARK DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-3620
Country : US
Telephone Number : 239-440-3361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2026
Last Update Date : 01/29/2026

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Directions to “ ANNIET BERNAL SOSA ” Practice Location

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