Individual
BRYAN J NEWCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2780 CLEVELAND AVE, #702, FORT MYERS, FL 33901-5857
(239) 343-3474
(239) 343-2968
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-3474
(239) 343-2968
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107631
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010441400
—
FL
Enumeration date
12/12/2013
Last updated
03/29/2021
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