Healthcare Provider Details

I. General information

NPI: 1932441870
Provider Name (Legal Business Name): COURTNEY JUSTMANN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 7TH ST N
NAPLES FL
34102-5754
US

IV. Provider business mailing address

PO BOX 26067
SALT LAKE CITY UT
84126-0067
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-3997
  • Fax: 239-624-8101
Mailing address:
  • Phone: 239-624-0400
  • Fax: 239-624-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME126856
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: