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NPI Code Detail

MEDICARE: DR. MADISON CONTOR MD

MEDICARE: DR. MADISON CONTOR 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
1390200000XStudent in an Organized Health Care Education/Training Program45099FL

General Provider Information

NPI Number : 1679403703
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MADISON CONTOR MD
Provider Business Mailing Address
First Line : 2781 LAKESHORE DR
Second Line :
City : SAGLE
State : ID
Zip : 83860-8711
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 636 DEL PRADO BLVD S
Second Line :
City : CAPE CORAL
State : FL
Zip : 33990-2668
Country : US
Telephone Number : 239-424-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ DR. MADISON CONTOR MD” Practice Location

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