Provider Demographics
NPI:1396772331
Name:LANDI, JOHN P (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:LANDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112019
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-0134
Mailing Address - Country:US
Mailing Address - Phone:239-624-0400
Mailing Address - Fax:239-624-0464
Practice Address - Street 1:9935 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1930
Practice Address - Country:US
Practice Address - Phone:239-624-4200
Practice Address - Fax:239-624-4241
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME68420208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC06522Medicare UPIN