Individual
DR. LAZARO OSCAR BRAVO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13340 METRO PKWY STE 400, FORT MYERS, FL 33966
(239) 343-1105
(239) 343-1106
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-1105
(239) 343-1106
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME108231
FL
207RP1001X
Pulmonary Disease Physician
ME108231
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002756600
—
FL
Enumeration date
05/10/2006
Last updated
03/24/2021
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