Individual
JOHN MICHAEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
632 DEL PRADO BLVD N, CAPE CORAL, FL 33909-2278
(239) 343-3800
(239) 343-4261
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(393) 433-8002
(239) 343-4261
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
ME173577
FL
208D00000X
General Practice Physician
326172
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127244600
—
FL
Enumeration date
03/21/2018
Last updated
07/10/2025
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