Provider Demographics
NPI:1134157498
Name:CASOLA, ROBERT P (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:CASOLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2531 CLEVELAND AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-4900
Mailing Address - Country:US
Mailing Address - Phone:239-334-7000
Mailing Address - Fax:239-334-7070
Practice Address - Street 1:2531 CLEVELAND AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-4900
Practice Address - Country:US
Practice Address - Phone:239-334-7000
Practice Address - Fax:239-334-7070
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5386207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002586169Medicaid
FL002586169Medicaid