PILOT HEALTHCARE P.L.
Ambulatory Health at Health Center Blvd, Bonita Springs, FL

License number
Florida ME51156
Category
Ambulatory Health
Type
Health Service
Owner
Name: DR. BRUCE MICHAEL BRIDEWELL M.D.
Title: PRESIDENT
Phone: (239) 992-7822
Address
Address 2
3501 Health Center Blvd #2230, Bonita Springs, FL 34135
20791 Three Oaks Pkwy #1209, Estero, FL 33929
National Provider ID: 1861687618
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PILOT HEALTHCARE, P.L

Bonita Springs, FL  -  Estero, FL

Inactive reason:
CONVERSION
Registration:
Nov 23, 2011
Inactive since:
Nov 23, 2011
Addresses:
3501 Health Ctr Blvd #2230, Bonita Springs, FL 34135 (Physical)
Estero, FL 33929 (Mailing)
PO Box 1209, Estero, FL 33929
State ID:
L11000138886
Business type:
Florida Limited Liability Company
Managers:
Bruce M Bridewell (Manager), 9941 St Moritz, Fort Myers, FL 33913 (Physical),Norma Henriquez (Manager), 9941 St Moritz, Fort Myers, FL 33913 (Physical)
Agent:
Bridewell, Bruce M., Dr,9941 St Moritz, Fort Myers, FL 33913 (Physical)
EIN:
65-0359656

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