NPI 1245671361

Jerald Vizzone, D.O.

Organisation Non-Pharmacy Dispensing Site Fort Myers, FL

Practice location

Address: 8595 College Pkwy #110, Fort Myers, FL 33919-5191
Phone: (239) 489-2290
Mailing address: 2295 NW Corporate Blvd #245, Boca Raton, FL 33431-7373

Authorised official

Name: Jerald Vizzone
Title: Physician
Phone: (239) 489-2290

Registered specialties

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X Licence OS11480 (FL)

Other Non-Pharmacy Dispensing Site providers in Florida →

Registry record

NPI: 1245671361
Entity type: Organization
NPI issued: 17 Jul 2013
Record last updated: 17 Jul 2013

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.