Healthcare Provider Details

I. General information

NPI: 1467564732
Provider Name (Legal Business Name): DAVID A PITTS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/06/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2338 IMMOKALEE RD STE 203
NAPLES FL
34110-1445
US

IV. Provider business mailing address

2338 IMMOKALEE RD STE 203
NAPLES FL
34110-1445
US

V. Phone/Fax

Practice location:
  • Phone: 239-919-4342
  • Fax:
Mailing address:
  • Phone: 239-919-4342
  • Fax: 239-919-4342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberD0060872
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME110950
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: