Individual
KRYSTAL SOVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
14601 HOPE CENTER LOOP, FORT MYERS, FL 33912-4707
(239) 334-7000
(239) 334-7070
Mailing address
14601 HOPE CENTER LOOP, FORT MYERS, FL 33912-4707
(239) 334-7000
(239) 334-7070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9110694
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9110694
FL
Other
Enumeration date
01/05/2018
Last updated
09/18/2023
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