Provider Demographics
NPI:1346704046
Name:O'TOOLE, JOSIE (NP)
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:
Last Name:O'TOOLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO 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:239-343-7474
Mailing Address - Fax:239-343-4185
Practice Address - Street 1:16230 SUMMERLIN RD STE 215
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5769
Practice Address - Country:US
Practice Address - Phone:239-343-7474
Practice Address - Fax:239-343-4185
Is Sole Proprietor?:No
Enumeration Date:2019-01-27
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018238363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL119449600Medicaid