Active NPI
Brandie N Gostigian, PA-C
- Dermatology Physician
- Fort Myers, FL
National Provider Identifier
1679825830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- PA9106877
- Practice address
- 13691 Metropolis Ave
Fort Myers, FL 33912-4318 - Phone
- (239) 561-3376
- Fax
- (239) 561-3020
- NPI assigned
- Oct 11, 2012
- Last updated
- Aug 7, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | PA9106877 | SC | Primary |
Addresses
Primary practice location
13691 Metropolis Ave
Fort Myers, FL 33912-4318
Mailing address
13691 Metropolis Ave
Fort Myers, FL 33912-4318
Phone (239) 561-3376
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9106877 | SC | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375833600000",
"number": "1679825830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13691 METROPOLIS AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124318",
"telephone_number": "239-561-3376",
"fax_number": "239-561-3020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13691 METROPOLIS AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124318",
"telephone_number": "239-561-3376",
"fax_number": "239-561-3020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSTIGIAN",
"first_name": "BRANDIE",
"middle_name": "N",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-11",
"last_updated": "2013-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "SC",
"license": "PA9106877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.