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General NPI Number Information
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NPI Number | 1720077159
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Entity Type | Individual
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Provider Name | GERARD JOSEPH FITZPATRICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 16230 SUMMERLIN RD SUITE 213-218
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City | FORT MYERS
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State | FL
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Zip | 33908
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Country | US
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Telephone | 239-334-3745
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Fax | 239-343-7451
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone |
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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 | 54845
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License Number State | MA
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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 | ME123914
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License Number State | FL
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