Individual
SHIVTAJ MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
14543 GLOBAL PARKWAY, SUITE 110, 2ND FLOOR, FORT MYERS, FL 33913-9446
(239) 264-7026
(239) 567-3679
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OT016993
PA
207RH0000X
Hematology (Internal Medicine) Physician
OS18673
FL
207RX0202X
Medical Oncology Physician
Primary
OS18673
FL
Other
Enumeration date
05/09/2016
Last updated
04/07/2026
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