Provider Demographics
NPI:1992798151
Name:ARROJO, GUSTAVO BERNARDO (MD)
Entity type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:BERNARDO
Last Name:ARROJO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:2109 59TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7015
Practice Address - Country:US
Practice Address - Phone:941-761-3777
Practice Address - Fax:941-761-3779
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00173098OtherRR MEDICARE PIN
FL251289100Medicaid
G42841Medicare UPIN