Provider Demographics
NPI:1770555203
Name:LLAMIDO, FELIX V (MD)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:V
Last Name:LLAMIDO
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 1:10517 BELLAGIO DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-7009
Mailing Address - Country:US
Mailing Address - Phone:239-225-0229
Mailing Address - Fax:239-225-0229
Practice Address - Street 1:10517 BELLAGIO DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-7009
Practice Address - Country:US
Practice Address - Phone:239-225-0229
Practice Address - Fax:239-225-0229
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME904232086S0122X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL29299AMedicare PIN
FL29299ZMedicare PIN
B77959Medicare UPIN
FLP00255007Medicare PIN
FL29299Medicare ID - Type Unspecified