Brunette Bastien Medical Services LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Cape Coral, FL. Organization (NPI-2).
NPI number1114652476
StatusActive
Last updated in NPPESFeb 1, 2023
Details
- NPI
- 1114652476
- Entity type
- Organization (NPI-2)
- Legal business name
- Brunette Bastien Medical Services LLC
- Organization subpart
- No
- Enumeration date
- Jul 20, 2022
- Certification date
- Feb 1, 2023
- Last updated
- Feb 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – |
Practice location
1425 Viscaya Pkwy Ste 101Cape Coral, FL 33990-3294
Phone 239-293-5829 · Fax 239-236-1200
Mailing address
1425 Viscaya Pkwy Ste 101Cape Coral, FL 33990-3294
Phone 239-919-4851 · Fax 239-236-1200
Authorized official
Brunette Bastien
Owner
2399194851
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