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Individual
MICHAEL ANTHONY FORTUNATO
Active
Individual
MICHAEL ANTHONY FORTUNATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
14743
WV
207Q00000X
Family Medicine Physician
Primary
ME143867
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550357057070
ANTHEM BCBS
—
Enumeration date
08/09/2005
Last updated
09/20/2023
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