Organization
PHYSICIANS PRIMARY CARE OF SOUTHWEST FLORIDA PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON BURDZY DO (MANAGING PHYSICIAN)
(239) 275-5522
Entity
Organization
Contact information
Practice address
1265 VISCAYA PKWY, CAPE CORAL, FL 33990-3237
(239) 573-7337
(239) 574-5883
Mailing address
12730 NEW BRITTANY BLVD STE 602, FORT MYERS, FL 33907-4690
(239) 275-5522
(239) 275-4464
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379245503
—
FL
Enumeration date
11/16/2005
Last updated
08/13/2024
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