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General NPI Number Information
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NPI Number | 1730151614
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Entity Type | Organization
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Legal Business Name | JAMES J. O'MAILIA, MD, PA
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 1553 MATTHEW DR
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City | FORT MYERS
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State | FL
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Zip | 33907-1734
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Country | US
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Telephone | 239-275-3695
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Fax | 239-275-5402
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Provider Business Mailing Address
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Address Line | 1553 MATTHEW DR
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City | FORT MYERS
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State | FL
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Zip | 33907-1734
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Country | US
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Telephone | 239-275-3695
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Fax | 239-275-5402
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES J O'MAILIA
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Credential | M.D.
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Telephone | 239-275-3695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME53585
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License Number State | FL
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