Individual
JOHN DIVITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3530 FRUITVILLE RD, SARASOTA, FL 34237-9026
(941) 552-8808
(941) 552-8805
Mailing address
3434 HANCOCK BRIDGE PKWY, STE 301, NORTH FORT MYERS, FL 33903-7094
(877) 856-3774
(239) 599-2625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101034
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292127800
—
FL
Enumeration date
06/23/2006
Last updated
02/26/2016
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