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General NPI Number Information
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NPI Number | 1598083313
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Entity Type | Individual
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Provider Name | ESTELA THANO D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 13411 PARKER COMMONS BLVD STE 101
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City | FORT MYERS
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State | FL
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Zip | 33912-1873
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Country | US
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Telephone | 239-415-4900
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Fax | 239-337-4901
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Provider Business Mailing Address
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Address Line | 13411 PARKER COMMONS BLVD STE 101
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City | FORT MYERS
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State | FL
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Zip | 33912-1873
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Country | US
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Telephone | 239-415-4900
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Fax | 239-337-4901
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | OS14092
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License Number State | FL
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