Healthcare Provider Details

I. General information

NPI: 1497793962
Provider Name (Legal Business Name): JOANN GORING JOURNIGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13340 METRO PKWY STE 200
FORT MYERS FL
33966-4818
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-0550
  • Fax: 239-343-0559
Mailing address:
  • Phone: 239-343-0550
  • Fax: 239-343-4013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2026-02742
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME134116
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number060749
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberP2694
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: