Provider Demographics
NPI:1801013404
Name:DIGIORGI, PAUL L (MD)
Entity Type:Individual
Prefix:PROF
First Name:PAUL
Middle Name:L
Last Name:DIGIORGI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-6341
Mailing Address - Fax:239-343-6342
Practice Address - Street 1:9981 S HEALTHPARK DR # 156
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3618
Practice Address - Country:US
Practice Address - Phone:239-343-6341
Practice Address - Fax:239-343-6342
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98545208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278749100Medicaid
FLME98545OtherMEDICAL LICENSE
FLME98545OtherMEDICAL LICENSE