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Individual

DR. THOMAS R CIVITELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2595 HARBOR BLVD, SUITE 207, PORT CHARLOTTE, FL 33952-6724
(941) 629-3937
(941) 627-2281
Mailing address
2595 HARBOR BLVD, SUITE 207, PORT CHARLOTTE, FL 33952-6724
(941) 629-3937
(941) 627-2281

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME17673
FL

Other

Enumeration date
07/19/2006
Last updated
07/08/2007
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