Individual provider · NPI-1

Dr. Joshua Bertollo, M.D.

Family Medicine · Port Charlotte, FL

NPI number1184329708
StatusActive
Last updated in NPPESJul 15, 2026

Details

NPI
1184329708
Entity type
Individual (NPI-1)
Name
Dr. Joshua Bertollo
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Apr 3, 2023
Certification date
Jul 15, 2026
Last updated
Jul 15, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineME178384FLYes

Practice location

4130 Tamiami Trl Unit 102
Port Charlotte, FL 33952-9207

Phone 941-787-7100

Mailing address

2675 Winkler Ave Ste 200
Fort Myers, FL 33901-9328

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