Individual
JERAD RARDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13685 DOCTORS WAY STE 350, FORT MYERS, FL 33912-4347
(239) 343-3800
(239) 343-3993
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-3800
(239) 343-3993
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
11010462
FL
363L00000X
Nurse Practitioner
RN148874
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003183133L
—
GA
05
—
115517400
—
FL
05
—
212731
—
AL
Enumeration date
09/30/2016
Last updated
03/20/2024
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