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Individual

BRIAN CLYDE LOBO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-0001
(352) 273-5199
Mailing address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 273-5199
(352) 392-6781

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
128442
OH
207Y00000X
Otolaryngology Physician
Primary
ME132089
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
021845000
FL
01
JB658Z
MEDICARE PTAN
Enumeration date
05/10/2011
Last updated
07/21/2022
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