Individual
JODAN PATHINATHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4761 S CLEVELAND AVE STE 3, FORT MYERS, FL 33907-1375
(239) 343-9722
(239) 343-9725
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9722
(239) 343-9725
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
ME176436
FL
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
307633
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129307200
—
FL
Enumeration date
06/02/2017
Last updated
02/05/2026
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