Individual
JENNIFER LUNSFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4997 ROYAL GULF CIR, FORT MYERS, FL 33966-7006
(239) 313-5049
Mailing address
4997 ROYAL GULF CIR, FORT MYERS, FL 33966-7006
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT18773
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L521-421-91-962-0
DRIVER'S LICENSE
FL
Enumeration date
12/11/2017
Last updated
12/11/2017
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