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General NPI Number Information
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NPI Number | 1033131883
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Entity Type | Individual
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Provider Name | JOHN STEPHEN WALSH MD
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 313 SW PINE ISLAND RD
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City | CAPE CORAL
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State | FL
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Zip | 33991-2043
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Country | US
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Telephone | 239-458-6755
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Fax |
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Provider Business Mailing Address
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Address Line | 313 SW PINE ISLAND RD
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City | CAPE CORAL
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State | FL
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Zip | 33991-2043
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Country | US
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Telephone | 239-458-6755
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 210572
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 274001
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME145947
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License Number State | FL
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