Individual
JOHN R LAMANNA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4300 KINGS HWY, STE 500, PORT CHARLOTTE, FL 33980-2917
(239) 344-2325
(941) 764-6176
Mailing address
PO BOX 1357, FORT MYERS, FL 33902-1357
(239) 278-3600
(239) 226-4650
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME93548
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1466149
UNITED
FL
05
—
274945900
—
FL
01
—
4091418
AETNA
FL
Enumeration date
12/19/2005
Last updated
05/04/2017
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