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1457351611
JOHN DISTASIO
FORT MYERS, FL
NPI
1457351611
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: FL ME57595)
Enumeration Date
2005-07-28
Last Update Date
2021-03-25
Business Address
JOHN DISTASIO M.D.
4751 S CLEVELAND AVE
FORT MYERS, FL 33907
Phone number: 239-343-9888
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Mailing Address
JOHN DISTASIO M.D.
PO BOX 2147
FT MYERS, FL 33902-2147
Phone number: 239-343-9888
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