MEDICARE: PETER J AMEGLIO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME131013	FL
2	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	ME131013	FL

General Provider Information

NPI Number	:	1104857747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER J AMEGLIO MD

Provider Business Mailing Address
First Line	:	6839 PORTO FINO CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4361
Country	:	US
Telephone Number	:	239-990-8138
Fax Number	:	239-237-3180

Provider Business Practice Location Address
First Line	:	6839 PORTO FINO CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4361
Country	:	US
Telephone Number	:	239-990-8138
Fax Number	:	238-237-3180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	01/26/2023

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