Organization
FLORIDA MENS VITALITY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL JOSEPH DEJOHN JR. (PRESIDENT)
(239) 220-1083
Entity
Organization
Contact information
Practice address
28901 TRAILS EDGE BLVD STE 202, BONITA SPRINGS, FL 34134-7588
(239) 220-1083
Mailing address
28901 TRAILS EDGE BLVD STE 202, BONITA SPRINGS, FL 34134-7588
(239) 220-1083
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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