NPI 1104005859
Advanced Pain Management Specialist
Practice location
- Address
- 6120 Winkler Rd Suite J, Fort Myers, FL 33919-8125
- Phone
- (239) 437-8000
- Mailing address
- PO Box 07400, Fort Myers, FL 33919-0400
Authorised official
- Name
- Jonathan S Daitch
- Title
- Physician
- Phone
- (239) 437-8000
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1104005859
- Entity type
- Organization
- NPI issued
- 30 Oct 2007
- Record last updated
- 3 Dec 2008
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.