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Individual

JOHN WASHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7152 COCA SABAL LN, FORT MYERS, FL 33908-4263
(239) 939-9939
(239) 931-5060
Mailing address
7152 COCA SABAL LN, FORT MYERS, FL 33908-4263
(239) 939-9939
(239) 931-5020

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9106825
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009809200
FL
01
1376885996
NPI
FL
01
HC769Y
MEDICARE
FL
Enumeration date
03/21/2013
Last updated
09/04/2015
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