Organization
BRUNETTE BASTIEN MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRUNETTE BASTIEN (OWNER)
(239) 919-4851
Entity
Organization
Contact information
Practice address
1425 VISCAYA PKWY STE 101, CAPE CORAL, FL 33990-3294
(239) 293-5829
(239) 236-1200
Mailing address
1425 VISCAYA PKWY STE 101, CAPE CORAL, FL 33990-3294
(239) 919-4851
(239) 236-1200
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/20/2022
Last updated
02/01/2023
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