Individual
SHANT JOHN MANOUSHAGIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9981 S HEALTHPARK DR, FORT MYERS, FL 33908-3618
(239) 343-6860
(239) 343-6162
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6860
(239) 343-6162
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
292937
NY
207RC0000X
Cardiovascular Disease Physician
MD457729
PA
207RC0000X
Cardiovascular Disease Physician
Primary
ME167029
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121555500
—
FL
Enumeration date
07/11/2012
Last updated
06/11/2024
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