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NPI Code Detail

MEDICARE: PABLO RODRIGO BANDERAS P.A.

MEDICARE: PABLO RODRIGO BANDERAS P.A.
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
1363AM0700XMedical Physician AssistantPA9100272FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609868835
Entity Type Code : Individual
Provider Name (Legal Business Name) : PABLO RODRIGO BANDERAS P.A.
Provider Business Mailing Address
First Line : 2675 WINKLER AVE FL 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 877-856-3774
Fax Number :
Provider Business Practice Location Address
First Line : 126 DEL PRADO BLVD N
Second Line : STE 104
City : CAPE CORAL
State : FL
Zip : 33909-2713
Country : US
Telephone Number : 239-573-1606
Fax Number : 239-573-1044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 01/20/2023

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Directions to “ PABLO RODRIGO BANDERAS P.A.” Practice Location

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