Healthcare Provider Details

I. General information

NPI: 1437146958
Provider Name (Legal Business Name): JOSEPH THOMAS DOYLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: JOSEPH THOMAS MASSOUD MD

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5051 CASTELLO DR SUITE 12
NAPLES FL
34103-8982
US

IV. Provider business mailing address

PO BOX 770208
NAPLES FL
34107-0208
US

V. Phone/Fax

Practice location:
  • Phone: 239-248-6640
  • Fax: 239-591-8039
Mailing address:
  • Phone: 239-248-6640
  • Fax: 239-591-8039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberME0058699
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: