Individual
FERNANDO ESTRADA BAEZA
Active
Sole proprietor
Yes
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) 343-3893
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9111765
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101459200
—
FL
Enumeration date
11/07/2018
Last updated
03/20/2024
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