MEDICARE: BRIAN A BABBIN M.D.

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
1	207ZP0101X	Anatomic Pathology Physician	054064	GA
2	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	ME100043	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00820733	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P929867	OTHER	FL	FREEDOM OPTIMUM
4	P105177	OTHER	FL	FREEDOM HEALTH
5	2359360	OTHER	FL	CIGNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811955818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN A BABBIN M.D.

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	:	13691 METRO PKWY STE 120
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4348
Country	:	US
Telephone Number	:	239-215-4066
Fax Number	:	239-237-2900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	01/19/2023

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Directions to “ BRIAN A BABBIN M.D.” Practice Location

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