Individual
ROBERT BRUCE GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 LOVELAND BLVD, PORT CHARLOTTE, FL 33980-5716
(941) 629-4500
(941) 629-4171
Mailing address
PO BOX 495156, PORT CHARLOTTE, FL 33949-5156
(941) 629-4500
(941) 629-4171
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
ME-0043075
FL
207RC0000X
Cardiovascular Disease Physician
Primary
ME0043075
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046539900
—
FL
01
—
060012031
RAILROAD MEDICARE
—
01
—
08128
BLUE SHIELD
—
01
—
2101031
GHI
—
01
—
283368
WELLCARE
—
01
—
5573046
AETNA
—
01
—
592171328-002
CHAMPUS/TRICARE
—
01
—
6583528002
CIGNA
—
Enumeration date
07/20/2006
Last updated
07/21/2022
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