Individual
JOSIAH DAVID MAGNUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3680 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
(239) 834-6106
Mailing address
3660 BROADWAY, FORT MYERS, FL 33901-8005
(239) 936-2316
(239) 834-6106
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
74006-20
WI
207U00000X
Nuclear Medicine Physician
Primary
ME156921
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/01/2018
Last updated
04/19/2023
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