Provider Demographics
NPI:1013172105
Name:BRUGGER, JONATHAN WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:WILLIAM
Last Name:BRUGGER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2401 UNIVERSITY PKWY
Mailing Address - Street 2:BUILDING 1, SUITE 205
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2973
Mailing Address - Country:US
Mailing Address - Phone:419-351-1200
Mailing Address - Fax:941-351-1201
Practice Address - Street 1:2401 UNIVERSITY PKWY
Practice Address - Street 2:BUILDING 1, SUITE 205
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2973
Practice Address - Country:US
Practice Address - Phone:419-351-1200
Practice Address - Fax:941-351-1201
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2020-09-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN57881207WX0107X, 207W00000X
FLME145189207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist