Individual
BRIAN LONGENDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4790 BARKLEY CIR, BLDG A, FT MYERS, FL 33907-7543
(239) 275-8882
(239) 275-6304
Mailing address
4790 BARKLEY CIR, BLDG A, FT MYERS, FL 33907-7543
(239) 275-8882
(239) 275-6304
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
FLOS0006673
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0971761
CIGNA
FL
01
—
100005455
RAILROAD MEDICARE
FL
01
—
1131942
UNITED HEALTHCARE
FL
01
—
1811979511
TRICARE
FL
01
—
205926
AVMED
FL
05
—
374229600
—
FL
01
—
4376307
AETNA
FL
01
—
80842
BCBS
FL
01
—
9591507
GHI
FL
Enumeration date
11/17/2005
Last updated
11/27/2023
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