Manuelidis, Laertes A
Manuelidis, Laertes A is an individual health care provider with primary practice located at 8381 Riverwalk Park Blvd Suite 1, Fort Myers FL 33919-8760. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatopathology is his primary health care specialty. Manuelidis, Laertes A can be contacted via phone (239) 936-5425.Contact Information
Primary practice address
8381 Riverwalk Park Blvd Suite 1
Fort Myers FL 33919-8760
Phone: (239) 936-5425
Fax: (239) 936-5176
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | ME87314 | Florida |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | ME87314 | Florida |
Profile Details
| NPI number | 1245220698 |
|---|---|
| LBN Legal business name | Manuelidis, Laertes A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245220698 | NPPES |
| Florida | Other | 7082420 | AETNA |
| Florida | Other | 78611 | AETNA |
| Florida | Other | P00038301 | AETNA |
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