Healthcare Provider Details

I. General information

NPI: 1407297724
Provider Name (Legal Business Name): JOHN VINCENT THOMPSON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2013
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 DEL PRADO BLVD S
CAPE CORAL FL
33990-2660
US

IV. Provider business mailing address

7331 COLLEGE PKWY STE 300
FORT MYERS FL
33907-5524
US

V. Phone/Fax

Practice location:
  • Phone: 239-337-2003
  • Fax: 239-337-3168
Mailing address:
  • Phone: 239-337-2003
  • Fax: 239-337-3168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberOS15087
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: