Provider Demographics
NPI:1710265889
Name:CASERTO, DANA (COTA)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:CASERTO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8957 SOMERSET BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4864
Mailing Address - Country:US
Mailing Address - Phone:239-822-2233
Mailing Address - Fax:
Practice Address - Street 1:16131 ROSERUSH CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3634
Practice Address - Country:US
Practice Address - Phone:239-432-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-24
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital