Individual
MR. ALEX RICHARD REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
12700 CREEKSIDE LN STE 301, FORT MYERS, FL 33919-3356
(239) 343-3780
(239) 343-3781
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-3780
(239) 343-3781
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9111617
FL
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9111617
MEDICAL LICENSE
FL
Enumeration date
01/18/2019
Last updated
07/02/2024
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