institution
Bruce S. West
Primary Care Clinic/Center in Fernandina Beach, Florida
NPI 1477761625

Bruce S. West is a Primary Care Clinic/Center based in Fernandina Beach, FL and is specialized in Primary Care. Bruce S. West practices in Fernandina Beach, FL. The NPI Number for Bruce S. West is 1477761625 and holds a License No. 0101042844 (Florida).

The current practice location address for Bruce S. West is 1340 S 18Th St, Fernandina Beach, FL and can be reached out via phone at 904-261-7707 and via fax at 904-261-8616.

Location: 1340 S 18Th St, Fernandina Beach, FL, 32034-4799
institution
Provider Profile Details
NPI Number
1477761625
Provider Name
Bruce S. West
Credential
Provider Entity Type
Organization
Address
1340 S 18Th St, Fernandina Beach, FL, 32034-4799
Phone Number
904-261-7707
Fax Number
904-261-8616
Provider Enumeration Date
05/20/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
006734952 05 VA
113328677A 05 GA
280146900 05 FL
institution
Provider Business Practice Location Address Details
Address
1340 S 18Th St
City
State
Zip
32034-4799
Phone Number
904-261-7707
Fax Number
904-261-8616
person
Provider Business Mailing Address Details
Address
1340 S 18Th St
City
State
Zip
32034-4799
Phone Number
904-261-7707
Fax Number
904-261-8616
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Health Service
Taxonomy
License No.
ME99878 (Florida)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
License No.
0101042844 (Virginia)
Definition
Definition to come...
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