Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 57881 | TN |
Y | 207W00000X | Ophthalmologist | ME145189 | FL |
N | 207WX0107X | Retina Specialist | 57881 | TN |
N | 207WX0107X | Retina Specialist | ME145189 | FL |
NPI | 1013172105 |
---|---|
Provider Name | Dr. Jonathan William Brugger |
First Address | Sarasota, FL 34243-2973 |
Second Address | Sarasota, FL 34243-2973 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2008 |
Last Update Date | 03/09/2020 |