Healthcare Provider Details

I. General information

NPI: 1396772331
Provider Name (Legal Business Name): JOHN P LANDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9935 TAMIAMI TRL N
NAPLES FL
34108-1930
US

IV. Provider business mailing address

PO BOX 112019
NAPLES FL
34108-0134
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-4200
  • Fax: 239-624-4241
Mailing address:
  • Phone: 239-624-0400
  • Fax: 239-624-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME68420
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: