Individual
MR. ALEXANDER HEISAKU IRIARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5216 CLAYTON CT, FORT MYERS, FL 33907-2116
(239) 343-8260
(239) 343-8261
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-8260
(239) 343-8261
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013550400
—
FL
Enumeration date
09/26/2014
Last updated
03/25/2021
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