Doctor Name: | DR. JAMES J. O'MAILIA |
NPI Number: | 1275530099 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME53585 |
Business Practice Address: | 1553 Matthew Dr Fort Myers, FL - 339071734 |
Business Phone Number: | 2392753695 |
Business Fax Number: | 2392755402 |
Mailing Address: | 1553 Matthew Dr, FORT MYERS |
State: | FL |
Postal Code: | 339071734 |
Phone Number: | 2392753695 |
Fax Number: | 2392755402 |
NPI Enumeration Date: | 07/07/2005 |
NPI Last Update Date: | 07/11/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/20/2006 |
NPI Reactivation Date: | 01/17/2007 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME53585 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |