Individual
JAMISON DICUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7370 COLLEGE PKWY STE 206, FORT MYERS, FL 33907-5558
(512) 730-3056
(888) 730-1925
Mailing address
13300 S CLEVELAND AVE STE 56, FORT MYERS, FL 33907-3871
(239) 344-9786
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9106955
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9106955
MEDICAL LICENSE
FL
Enumeration date
10/29/2012
Last updated
11/27/2023
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