Individual
DR. JOSEPH G MAGNANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1510 ROYAL PALM SQUARE BLVD, SUITE 101, FORT MYERS, FL 33919-1068
(239) 694-8346
(239) 936-6272
Mailing address
1510 ROYAL PALM SQUARE BLVD, SUITE 101, FORT MYERS, FL 33919-1068
(239) 694-8346
(239) 936-6272
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME94904
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124205349
FACILITY NPI
FL
01
—
ME94904
STATE LICENSE
FL
Enumeration date
07/17/2006
Last updated
10/07/2008
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