Individual
DR. KHASHAYAR ALEX DANESHMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9981 HEALTHPARK DRIVE, FT MYERS, FL 33908
(239) 343-5651
(239) 343-5652
Mailing address
PO BOX 2147, FT MYERS, FL 33902-2147
(239) 343-6001
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
OS9802
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275563700
—
FL
Enumeration date
07/16/2006
Last updated
08/19/2020
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