Provider Demographics
NPI:1548748098
Name:PAUL, JAMES JOSEPH
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:PAUL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 GULF REFLECTIONS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-8511
Mailing Address - Country:US
Mailing Address - Phone:727-667-3644
Mailing Address - Fax:
Practice Address - Street 1:11001 GULF REFLECTIONS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-8511
Practice Address - Country:US
Practice Address - Phone:727-667-3644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL188432085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging