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NPI Code Detail

MEDICARE: DR. WILLIAM SCOTT WITTENBORN M.D.

MEDICARE: DR. WILLIAM SCOTT WITTENBORN M.D.
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
1208200000XPlastic Surgery PhysicianME87881FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710983218
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM SCOTT WITTENBORN M.D.
Provider Business Mailing Address
First Line : 13300 S CLEVELAND AVE STE 56
Second Line : BOX 261
City : FORT MYERS
State : FL
Zip : 33907-3871
Country : US
Telephone Number : 239-561-2313
Fax Number : 888-500-2420
Provider Business Practice Location Address
First Line : 6811 PORTO FINO CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4354
Country : US
Telephone Number : 239-561-2313
Fax Number : 888-500-2420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 02/27/2018

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