10D0856862 CLIA NUMBER - BRUCE M BRIDEWELL MD PA

Laboratory Demographics

CLIA Number: 10D0856862

Facility Name: BRUCE M BRIDEWELL MD PA

Facility Address:
10201 ARCOS AVE #201
ESTERO, FL
ZIP 33928
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Facility Phone Number: 239 992-7822

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144293044

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D0856862
LAB Type	Physician Office
Facility Name	BRUCE M BRIDEWELL MD PA
Street	10201 ARCOS AVE #201
City	ESTERO
State	FL
ZIP	33928
Phone	239 992-7822
CertificateType	4
CertificateEffectiveDate	11/15/2022
CertificateExpirationDate	11/14/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024