Individual
JANSI PROBAKARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 MASON CORBIN CT, FORT MYERS, FL 33907
(239) 275-6678
(239) 275-1785
Mailing address
5050 MASON CORBIN CT, FORT MYERS, FL 33907
(239) 275-6678
(239) 275-1785
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0046551
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43792100
—
FL
Enumeration date
09/21/2006
Last updated
07/08/2007
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