Organization
ADVANCED PAIN MANAGEMENT SPECIALIST
Active
Organization
ADVANCED PAIN MANAGEMENT SPECIALIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN S DAITCH (PHYSICIAN)
(239) 437-8000
Entity
Organization
Contact information
Practice address
6120 WINKLER RD, SUITE J, FORT MYERS, FL 33919-8125
(239) 437-8000
Mailing address
PO BOX 07400, FORT MYERS, FL 33919-0400
(239) 437-8000
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
BD1688641
FL
Other
Enumeration date
10/30/2007
Last updated
12/03/2008
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