Individual
DR. MICHAEL D'AGOSTA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11215 METRO PKWY STE 100, FORT MYERS, FL 33966-1206
(239) 208-2212
Mailing address
11215 METRO PKWY STE 100, FORT MYERS, FL 33966-1206
(239) 208-2212
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2023040078
MO
2084P0800X
Psychiatry Physician
Primary
OS19880
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/26/2019
Last updated
04/18/2024
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