Healthcare Provider Details

I. General information

NPI: 1114921483
Provider Name (Legal Business Name): JOSEPH S. BORREGGINE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date: 03/21/2006
Reactivation Date: 04/11/2006

III. Provider practice location address

2540 WINKLER AVE
FORT MYERS FL
33901-9338
US

IV. Provider business mailing address

2540 WINKLER AVE
FORT MYERS FL
33901-9338
US

V. Phone/Fax

Practice location:
  • Phone: 239-278-4100
  • Fax: 239-278-3907
Mailing address:
  • Phone: 239-278-4100
  • Fax: 239-278-3907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number3812
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: