Individual
DR. CHARLES GEORGE BRISENO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9131 COLLEGE POINTE CT, FORT MYERS, FL 33919
(239) 432-0101
(239) 432-9659
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9100
(239) 343-9108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME80345
FL
208M00000X
Hospitalist Physician
Primary
ME80345
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260152400
—
FL
Enumeration date
08/10/2005
Last updated
11/18/2024
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