BRUCE A. PATZWAHL PA-C NPI 1194787804

NPI Information

NPI: 1194787804
Provider Name: BRUCE A. PATZWAHL, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
12700 CREEKSIDE LN
SUITE 101
FORT MYERS, FL
ZIP 33919
Phone: (239) 432-0774
Get Directions

Bruce A. Patzwahl, PA-C is a surgical physician assistant in Fort Myers, FL. Bruce A. Patzwahl, PA-C NPI is 1194787804. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12700 CREEKSIDE LN
SUITE 101
FORT MYERS, FL
ZIP 33919-356
Phone: (239) 432-0774
Fax: (239) 432-9404

The enumeration date for this NPI number is 4/6/2006 and was last updated on 2/12/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207T00000X	Neurological Surgery		PA1782	FLORIDA	No
2	363AM0700X	Physician Assistant	Medical	PA1782	FLORIDA	No
3	363AS0400X	Physician Assistant	Surgical	PA1782	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1290460001	MEDICARE NSC	FLORIDA
2	E1522Z	MEDICARE PIN	FLORIDA
3	2902397-00	MEDICAID	FLORIDA
4	Y00LX	OTHER	FLORIDA	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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