Healthcare Provider Details

I. General information

NPI: 1780655977
Provider Name (Legal Business Name): DAVID SCOTT ANDREW DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7117 CONGDON RD APT 200
FORT MYERS FL
33908-5004
US

IV. Provider business mailing address

7117 CONGDON RD APT 200
FORT MYERS FL
33908-5004
US

V. Phone/Fax

Practice location:
  • Phone: 239-936-5400
  • Fax: 239-936-9572
Mailing address:
  • Phone: 239-936-5400
  • Fax: 239-936-9572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO0001326
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO0001326
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: