Provider Demographics
NPI:1518216076
Name:JOHN P. LANDI, M.D., LLC
Entity Type:Organization
Organization Name:JOHN P. LANDI, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-403-0800
Mailing Address - Street 1:20 10TH ST N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6217
Mailing Address - Country:US
Mailing Address - Phone:239-403-0800
Mailing Address - Fax:239-403-0808
Practice Address - Street 1:20 10TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6217
Practice Address - Country:US
Practice Address - Phone:239-403-0800
Practice Address - Fax:239-403-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOSR853261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical