| Doctor Name: | JAMISON DICUS |
| NPI Number: | 1013261197 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA9106955 |
| Business Practice Address: | 6150 Diamond Centre Ct Suite 1300 Fort Myers, FL - 339124368 |
| Business Phone Number: | 3693449786 |
| Business Fax Number: | |
| Mailing Address: | 13300 S Cleveland Ave Ste 56, FORT MYERS |
| State: | FL |
| Postal Code: | 339073871 |
| Phone Number: | 2393449786 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2012 |
| NPI Last Update Date: | 10/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA9106955 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |