Provider Demographics
NPI:1184938581
Name:JAMES S AMONTREE, MD, PA
Entity type:Organization
Organization Name:JAMES S AMONTREE, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:S
Authorized Official - Last Name:AMONTREE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-764-6664
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:2400 HARBOR BLVD STE 9
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5038
Practice Address - Country:US
Practice Address - Phone:941-764-6664
Practice Address - Fax:941-761-6768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JAMES S AMONTREE, MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-07-28
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42538207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty