Individual
MS. ALEISHA NICOLE THEARLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6821 PALISADES PARK CT STE 1, FORT MYERS, FL 33912-7131
(239) 210-4660
Mailing address
5541 SPECTRA CIR APT 203, FORT MYERS, FL 33908-5384
(724) 816-4839
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9110478
FL
Other
Enumeration date
07/18/2017
Last updated
02/21/2025
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