Individual
JESS ITZIKOWITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13340 METRO PARKWAY, SUITE 200, FORT MYERS, FL 33966-4703
(239) 343-0550
(239) 343-0559
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 424-1449
(239) 424-1423
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9110712
FL
Other
Enumeration date
09/18/2017
Last updated
03/17/2018
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