Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME109088 | FL |
NPI | 1871703488 |
---|---|
Provider Name | Dr. Jason Nemitz |
First Address | Fort Myers, FL 33901-4900 |
Second Address | Fort Myers, FL 33901-4900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 12/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003375300 | (05) | FL |