Active NPI 1013981364 Individual Practitioner Female Practitioner

Dr. Anne K. Mcbride , MD

Dermatology • Venice, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Anne Mcbride, MD is a certified Dermatology practicing in Venice, FL. With approximately 38 years of clinical experience since graduating from West Virginia University School Of Medicine in 1988, Dr. Mcbride delivers high-quality medical care to the local community at 1295 JACARANDA BLVD.

Dr. Mcbride is affiliated with Aqua Dermatology Of Florida, Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1295 Jacaranda Blvd

Venice, FL 342924522

Telephone 9414841510

Fax 9414841071

Medicare Profile & Education

Medical School

West Virginia University School Of Medicine

Graduation Year

1988

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Venice, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

38 Yrs +12.2 yrs vs City Avg

City Avg: 25.8 Yrs

State Avg: 23.7 Yrs

Regional Practice Density

7 Specialists

Practicing in Venice, FL (1273 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

59.1% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mcbride (38 Years) 38 Yrs

Venice Specialty Average (25.8 Years) 25.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,519	600	$14.00	$6.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,390	946	$270.00	$124.33
17000 Destruction of skin growth	1,103	776	$141.96	$43.99
11102 Tangential biopsy of single skin lesion	682	560	$208.89	$86.79
99213 Established patient office or other outpatient visit, typically 15 minutes	511	410	$191.00	$88.24
11103 Biopsy of related skin growth, each additional growth	387	242	$104.91	$47.66
17110 Destruction of up to 14 skin growths	203	187	$236.59	$98.65
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	164	132	$254.00	$88.29
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	131	109	$287.00	$106.75
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	113	90	$286.00	$109.20
17004 Destruction of precancer skin growth, 15 or more growths	110	90	$352.00	$159.72
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	81	72	$119.00	$54.69
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	81	66	$376.00	$152.23
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	77	77	$355.38	$163.71
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	57	17	$2.00	$0.99
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	57	51	$326.00	$143.42
69100 Biopsy of ear	45	42	$201.00	$63.78
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	39	37	$255.00	$85.29
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	35	33	$290.00	$115.33
11900 Injection into skin growth, 1-7 growths	24	17	$122.00	$36.83
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	22	21	$407.00	$173.32
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	21	20	$398.00	$168.88
17260 Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less	17	15	$211.00	$87.70
17111 Destruction of skin growth, 15 or more growths	15	14	$278.00	$118.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	4,346	681	$14.00	$6.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,652	1,072	$274.39	$127.07
17000 Destruction of skin growth	1,147	829	$144.69	$45.90
11102 Tangential biopsy of single skin lesion	739	602	$218.64	$91.30
11103 Biopsy of related skin growth, each additional growth	442	280	$108.88	$49.65
99213 Established patient office or other outpatient visit, typically 15 minutes	319	276	$194.31	$89.88
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	208	161	$263.13	$88.76
17110 Destruction of up to 14 skin growths	175	162	$242.46	$95.84
17004 Destruction of precancer skin growth, 15 or more growths	143	119	$367.12	$167.51
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	135	123	$295.96	$121.24
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	121	107	$295.55	$115.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	107	107	$362.33	$165.65
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	94	81	$388.57	$164.26
69100 Biopsy of ear	57	47	$210.91	$61.63
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	51	48	$265.29	$93.27
11312 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	45	42	$342.29	$147.23
11307 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	39	33	$300.74	$120.50
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	34	34	$121.74	$56.07
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	33	11	$3.00	$1.08
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	29	25	$418.31	$177.27
11900 Injection into skin growth, 1-7 growths	19	14	$124.68	$37.29
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	15	15	$245.00	$112.41
10040 Acne surgery	15	15	$251.60	$107.27
11303 Shaving of over 2.0 centimeters skin growth of the trunk, arms, or legs	14	13	$328.71	$134.89
17111 Destruction of skin growth, 15 or more growths	11	11	$285.36	$118.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	4,139	670	$14.00	$6.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,515	1,026	$282.00	$128.03
17000 Destruction of skin growth	1,148	828	$143.00	$49.10
11102 Tangential biopsy of single skin lesion	971	774	$223.00	$98.42
11103 Biopsy of related skin growth, each additional growth	507	318	$115.00	$51.03
99213 Established patient office or other outpatient visit, typically 15 minutes	501	407	$199.00	$91.16
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	124	124	$370.00	$169.21
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	105	86	$388.00	$161.61
17004 Destruction of precancer skin growth, 15 or more growths	100	90	$359.00	$167.90
69100 Biopsy of ear	54	48	$217.00	$67.56
17110 Destruction of up to 14 skin growths	41	39	$244.00	$108.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	33	33	$121.00	$56.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$240.85	$113.31
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	19	17	$270.00	$103.46
11900 Injection into skin growth, 1-7 growths	17	12	$123.00	$36.71
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	17	15	$310.00	$131.13
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	12	11	$421.00	$170.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	4,050	721	$14.00	$6.33
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,477	1,054	$281.80	$129.99
17000 Destruction of skin growth	1,220	888	$142.74	$47.04
11102 Tangential biopsy of single skin lesion	906	743	$222.65	$96.66
11103 Biopsy of related skin growth, each additional growth	505	324	$114.75	$52.19
99213 Established patient office or other outpatient visit, typically 15 minutes	430	365	$197.76	$91.36
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	166	166	$369.57	$169.23
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	129	104	$269.72	$102.94
17004 Destruction of precancer skin growth, 15 or more growths	105	96	$358.50	$164.96
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	99	78	$387.43	$157.73
69100 Biopsy of ear	65	59	$215.95	$66.40
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	49	46	$309.14	$128.90
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	48	48	$243.81	$113.38
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	45	37	$306.51	$117.88
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	44	19	$4.00	$1.26
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	38	38	$119.84	$56.07
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	31	26	$270.84	$116.83
17110 Destruction of up to 14 skin growths	28	27	$241.68	$102.23
11900 Injection into skin growth, 1-7 growths	23	18	$123.00	$40.45
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	17	16	$417.59	$187.71
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	14	11	$411.00	$162.14
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	14	14	$218.86	$69.19
17260 Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less	13	12	$216.00	$71.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	4,003	710	$13.00	$5.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,405	1,062	$236.00	$109.56
17000 Destruction of skin growth	1,187	908	$143.00	$47.68
11102 Tangential biopsy of single skin lesion	897	729	$218.00	$95.69
11103 Biopsy of related skin growth, each additional growth	478	286	$117.00	$53.33
99213 Established patient office or other outpatient visit, typically 15 minutes	406	301	$163.00	$75.54
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	236	236	$236.00	$108.89
17004 Destruction of precancer skin growth, 15 or more growths	124	109	$343.00	$157.50
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	115	104	$100.00	$45.73
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	91	78	$264.00	$110.37
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	72	66	$385.00	$159.38
69100 Biopsy of ear	55	50	$215.00	$63.04
17110 Destruction of up to 14 skin growths	44	42	$243.00	$102.95
99202 New patient office or other outpatient visit, typically 20 minutes	37	37	$167.00	$76.56
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	34	20	$4.00	$1.46
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	31	28	$216.00	$77.18
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	29	28	$306.00	$136.29
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	23	19	$420.00	$176.75
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	22	11	$785.00	$388.71
11900 Injection into skin growth, 1-7 growths	22	19	$120.00	$39.08
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	21	21	$299.00	$131.66
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	15	15	$268.00	$111.34
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	14	11	$281.00	$129.07
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	11	11	$252.00	$95.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	5,116	800	$13.00	$5.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,714	1,211	$235.00	$107.94
17000 Destruction of skin growth	1,380	981	$145.00	$51.81
11102 Tangential biopsy of single skin lesion	838	686	$217.00	$93.27
99213 Established patient office or other outpatient visit, typically 15 minutes	413	331	$161.00	$73.89
11103 Biopsy of related skin growth, each additional growth	328	217	$117.00	$52.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	217	217	$239.00	$107.55
17004 Destruction of precancer skin growth, 15 or more growths	142	119	$338.00	$151.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	131	120	$98.00	$44.69
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	68	55	$394.00	$166.40
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	60	51	$264.00	$107.25
69100 Biopsy of ear	47	43	$218.00	$91.73
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	45	30	$810.00	$384.11
99202 New patient office or other outpatient visit, typically 20 minutes	38	38	$167.00	$74.40
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	35	30	$261.00	$116.03
17110 Destruction of up to 14 skin growths	34	34	$241.00	$105.99
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	33	24	$4.00	$1.59
11900 Injection into skin growth, 1-7 growths	32	26	$121.00	$41.60
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	22	22	$214.00	$81.17
11302 Shaving of skin growth of body, arms, or legs, 1.1-2.0 cm	21	20	$310.00	$126.28
99201 New patient office or other outpatient visit, typically 10 minutes	18	18	$101.00	$45.49
11305 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less	15	15	$222.00	$91.04
11306 Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm	13	13	$267.00	$120.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	4,955	786	$12.10	$5.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,571	1,097	$232.08	$106.46
17000 Destruction of skin growth	1,348	952	$146.42	$49.75
11100 Biopsy of single growth of skin and/or tissue	996	785	$232.16	$99.81
99213 Established patient office or other outpatient visit, typically 15 minutes	543	393	$157.64	$72.03
11101 Biopsy of each additional growth of skin and/or tissue	491	317	$74.38	$32.92
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	241	241	$238.58	$107.67
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	188	157	$94.94	$43.25
17004 Destruction of precancer skin growth, 15 or more growths	174	145	$321.68	$143.42
17110 Destruction of up to 14 skin growths	168	159	$243.60	$108.82
77401 Radiation treatment delivery, superficial	70	12	$53.70	$24.11
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	66	58	$391.32	$161.58
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	57	24	$5.00	$1.81
69100 Biopsy of ear	56	53	$222.52	$73.39
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	42	24	$735.62	$398.12
99202 New patient office or other outpatient visit, typically 20 minutes	32	32	$163.30	$74.33
11900 Injection into skin growth, 1-7 growths	30	23	$124.82	$39.10
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	30	24	$241.14	$109.46
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	16	14	$321.00	$134.46
17260 Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less	13	12	$214.32	$84.67
99201 New patient office or other outpatient visit, typically 10 minutes	12	12	$97.54	$44.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	4,912	734	$12.53	$5.50
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,462	1,019	$228.61	$104.09
17000 Destruction of skin growth	1,256	893	$144.61	$48.02
11100 Biopsy of single growth of skin and/or tissue	982	785	$223.35	$92.50
99213 Established patient office or other outpatient visit, typically 15 minutes	473	358	$155.78	$70.89
11101 Biopsy of each additional growth of skin and/or tissue	469	313	$72.72	$32.33
17110 Destruction of up to 14 skin growths	304	264	$237.15	$105.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	300	300	$233.94	$105.92
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	239	206	$92.96	$42.05
17004 Destruction of precancer skin growth, 15 or more growths	206	163	$326.63	$144.59
77401 Radiation treatment delivery, superficial	89	15	$52.42	$23.40
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	85	78	$379.51	$162.77
69100 Biopsy of ear	46	41	$217.43	$68.43
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	40	23	$5.00	$1.79
11900 Injection into skin growth, 1-7 growths	27	22	$120.91	$38.30
99202 New patient office or other outpatient visit, typically 20 minutes	26	26	$161.27	$72.95
17111 Destruction of skin growth, 15 or more growths	19	16	$284.97	$120.87
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	19	19	$42.07	$19.48
17260 Destruction of cancer skin growth of trunk, arms, or legs, 0.5 cm or less	19	17	$207.29	$75.61
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	16	14	$416.55	$163.97
99201 New patient office or other outpatient visit, typically 10 minutes	14	14	$94.66	$42.70

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License FL ME81301

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Dermatology

NUCC Taxonomy Code: 207N00000X

State License VA 0101-226152

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Medicare Ptan

AI305V (FL)

Hospital & Practice Group Affiliations

Aqua Dermatology Of Florida, Pa

14840 Tamiami Trl, North Port, FL 342872701

Phone: 9415641542

Aqua Dermatology Of Florida, Pa

1015 Crosspointe Dr, Naples, FL 341100949

Phone: 2395969075

Aqua Dermatology Of Florida, Pa

1295 Jacaranda Blvd, Venice, FL 342924522

Phone: 9414841510

Aqua Dermatology Of Florida, Pa

2481 Bobcat Village Ctr Rd, North Port, FL 342888493

Phone: 9419550360

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Ashley Goldberg Sanderson , PA

Physician Assistant

NPI 1407308729

Physician Assistant

Dr. Matthew Bonanno , MD

Surgery - Plastic and Reconstructive Surgery

NPI 1679678338

Doctor of Medicine (M.D.)

Dr. Robert Taylor , MD

Dermatology

NPI 1720189657

Doctor of Medicine (M.D.)

Michael Banuchi , PA-C

Physician Assistant

NPI 1851472187

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 07, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location July 07, 2015

Registered at 1295 JACARANDA BLVD, VENICE, FL 342924522 (Tel: 9414841510)

📍

Updated Business Mailing Address July 07, 2015

Registered at 15051 S TAMIAMI TRL, SUITE 203, FORT MYERS, FL 339085182 (Tel: 2394378810)

👤

Provider Name / Credentials Updated July 07, 2015

Recorded as ANNE MCBRIDE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 07, 2015

Dermatology (License #ME81301 in FL)

🟢

Initial NPI Registration & Enumeration February 14, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013981364

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 14, 2006

Last Update: July 07, 2015

Sole Proprietor: No

Update or Correct Profile

Mailing Address

15051 S Tamiami Trl, Suite 203

Fort Myers, FL 339085182

Phone: 2394378810

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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