Individual
BRIAN MENICHELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15420 COLLIER BLVD, NAPLES, FL 34120
(239) 624-0600
(239) 624-0601
Mailing address
15420 COLLIER BLVD, NAPLES, FL 34120
(239) 624-0600
(239) 624-0601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME113559
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024264900
—
FL
01
—
14M1B
BCBS
FL
Enumeration date
07/13/2007
Last updated
09/08/2022
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