George P. Fitzgerald III MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME 0020292 Issued in FL

Legal business name

GEORGE P. FITZGERALD III MD

Practice address

3594 Broadway
Suite E
Fort Myers, FL 33901-8016

Phone

(239) 334-8888

Fax

(239) 334-9534

NPI assigned

Jun 25, 2014

Last updated

Jun 25, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jeri Ann Ksiazek

Title

Office Manager

Phone

(239) 334-8888

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1144635426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3594 BROADWAY AVENUE",
            "address_2": "SUITE E",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018017",
            "telephone_number": "239-334-8888",
            "fax_number": "239-334-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3594 BROADWAY",
            "address_2": "SUITE E",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018016",
            "telephone_number": "239-334-8888",
            "fax_number": "239-334-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE P. FITZGERALD III MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "KSIAZEK",
        "authorized_official_first_name": "JERI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "239-334-8888",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 0020292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.