Individual
JOSEPH CARMINE FANTONE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0237
(352) 293-6249
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-0237
(352) 392-6249
Taxonomy
Speciality
Code
Description
License number
State
207ZI0100X
Immunopathology Physician
4301043224
MI
207ZP0101X
Anatomic Pathology Physician
4301043224
MI
207ZP0101X
Anatomic Pathology Physician
Primary
ME108855
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003164400
—
FL
05
—
1443784
—
MI
Enumeration date
10/18/2006
Last updated
04/01/2011
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