Healthcare Provider Details

I. General information

NPI: 1982758280
Provider Name (Legal Business Name): ANNE MCNAMARA DPM PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14290 METROPOLIS AVE STE 1
FORT MYERS FL
33912-4534
US

IV. Provider business mailing address

14290 METROPOLIS AVE STE 1
FORT MYERS FL
33912-4534
US

V. Phone/Fax

Practice location:
  • Phone: 239-275-1114
  • Fax: 239-275-0498
Mailing address:
  • Phone: 239-275-1114
  • Fax: 239-275-0498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO-3076
License Number StateFL

VIII. Authorized Official

Name: DR. ANNE MCNAMARA
Title or Position: PRESIDENT
Credential: DPM
Phone: 239-275-1114