Healthcare Provider Details

I. General information

NPI: 1457399594
Provider Name (Legal Business Name): JOHN L HOWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 BARKLEY CIR STE. 100 & 101
FORT MYERS FL
33907-4514
US

IV. Provider business mailing address

13716 BRYNWOOD LN
FORT MYERS FL
33912-1607
US

V. Phone/Fax

Practice location:
  • Phone: 239-938-3500
  • Fax: 239-278-0588
Mailing address:
  • Phone: 239-482-5213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME59979
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME59979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: