Healthcare Provider Details

I. General information

NPI: 1679751549
Provider Name (Legal Business Name): DR. JOHN J. ADLER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 06/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1722 DEL PRADO BLVD S SUITE 12
CAPE CORAL FL
33990-5525
US

IV. Provider business mailing address

1722 DEL PRADO BLVD S SUITE 12
CAPE CORAL FL
33990-5525
US

V. Phone/Fax

Practice location:
  • Phone: 239-573-9200
  • Fax: 855-376-5040
Mailing address:
  • Phone: 239-573-9200
  • Fax: 855-376-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO2995
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO2068
License Number StateFL

VIII. Authorized Official

Name: DR. JOHN J ADLER
Title or Position: PRESIDENT
Credential: DPM
Phone: 239-573-9200