Individual
DR. JOSEPH GARY FORTUNATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
14027 5TH ST, DADE CITY, FL 33525-4302
(352) 518-2000
(352) 567-5193
Mailing address
PO BOX 232, DADE CITY, FL 33526-0232
(352) 518-2000
(352) 567-5193
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
18129
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003355300
—
FL
Enumeration date
12/05/2006
Last updated
03/21/2012
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