Individual
ANTHONY CEPERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3637 DR MARTIN LUTHER KING BLVD STE 101, FORT MYERS, FL 33916-4601
(239) 343-4910
(239) 343-4911
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-4910
(239) 343-4911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9118823
FL
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123496100
—
FL
Enumeration date
06/20/2024
Last updated
09/11/2024
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