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NPI Code Detail

MEDICARE: PILOT HEALTHCARE P.L.

MEDICARE: PILOT HEALTHCARE P.L.
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
1261QH0100XHealth Service Clinic/CenterME51156FL

General Provider Information

NPI Number : 1861687618
Entity Type Code : Organization
Provider Name (Legal Business Name) : PILOT HEALTHCARE P.L.
Provider Business Mailing Address
First Line : 20791 THREE OAKS PKWY
Second Line : #1209
City : ESTERO
State : FL
Zip : 33929-3670
Country : US
Telephone Number : 239-992-7822
Fax Number : 239-947-5687
Provider Business Practice Location Address
First Line : 3501 HEALTH CENTER BLVD
Second Line : #2230
City : BONITA SPRINGS
State : FL
Zip : 34135-8127
Country : US
Telephone Number : 239-992-7822
Fax Number : 239-947-5687
Authorized Official
Title or Position : PRESIDENT
Name : DR. BRUCE MICHAEL BRIDEWELL
Credential : M.D.
Telephone Number : 239-992-7822
Provider Enumeration Date : 09/13/2007
Last Update Date : 03/01/2013

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Directions to “PILOT HEALTHCARE P.L. ” Practice Location

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