Provider Demographics
NPI:1508880337
Name:SYLVESTER, JOHN E (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:SYLVESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:8946 77TH TER E
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-6421
Practice Address - Country:US
Practice Address - Phone:941-907-9053
Practice Address - Fax:941-907-9473
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000254382085R0001X
FLME1059712085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL353595OtherAVMED
FL146YSOtherBCBS FL
FL4077743OtherAETNA
FLP01047443OtherRAILROAD MEDICARE
FLP931072Medicaid
FL140878OtherUNIVERSAL
FL0055236-00Medicaid
FL01677174OtherAMERIGROUP
FLP118845OtherFREEDOM
FL3598126OtherCIGNA
FLP931072OtherOPTIMUM
WA1040831Medicaid
WA000178904Medicare PIN
FLCU630XMedicare PIN
FL140878OtherUNIVERSAL
FL3598126OtherCIGNA