Individual
DWIGHT L. FITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5325 E STATE ROAD 64, BRADENTON, FL 34208-5534
(941) 220-6263
(864) 909-9100
Mailing address
1860 BOY SCOUT DR STE 201, FORT MYERS, FL 33907-2119
(239) 215-1180
(239) 215-1180
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME0095935
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276150500
—
FL
01
—
363218
WELLCARE PROVIDER #
FL
01
—
4969206
CIGNA PROVIDER #
FL
01
—
53040
BCBS FL PROVIDER #
FL
01
—
7229796
AETNA PROVIDER #
FL
01
—
ME95935
METCARE PROVIDER #
FL
01
—
OV540
MEDICARE
FL
01
—
OV541
MEDICARE
FL
01
—
P00348796
RAILROAD MEDICARE PIN #
FL
Enumeration date
05/30/2006
Last updated
08/23/2022
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