Organization
LAKSHMI BUSHAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAKSHMI BUSHAN M.D. (OWNER)
(239) 275-5339
Entity
Organization
Contact information
Practice address
4755 SUMMERLIN RD, SUITE 8, FORT MYERS, FL 33919-1073
(239) 275-5339
(239) 275-5595
Mailing address
4755 SUMMERLIN RD, SUITE 8, FORT MYERS, FL 33919-1073
(239) 275-5339
(239) 275-5595
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME57213
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064857400
—
FL
Enumeration date
03/29/2012
Last updated
03/29/2012
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