MEDICARE: DR. DONALD JOHN DIPASCO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME86270	FL

General Provider Information

NPI Number	:	1396745006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD JOHN DIPASCO M.D.

Provider Business Mailing Address
First Line	:	1865 VETERANS PARK DR
Second Line	:	SUITE 202
City	:	NAPLES
State	:	FL
Zip	:	34109-0447
Country	:	US
Telephone Number	:	239-596-1111
Fax Number	:	239-596-1659

Provider Business Practice Location Address
First Line	:	1865 VETERANS PARK DR
Second Line	:	SUITE 202
City	:	NAPLES
State	:	FL
Zip	:	34109-0447
Country	:	US
Telephone Number	:	239-596-1111
Fax Number	:	239-596-1659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	08/14/2012

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