Individual
JENNIE BOISVERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2776 CLEVELAND AVE, FORT MYERS, FL 33901-5864
(239) 343-1614
(239) 343-3695
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-1614
(239) 343-3695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9117599
FL
363A00000X
Physician Assistant
Primary
PA9117599
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119070600
—
FL
Enumeration date
10/03/2022
Last updated
10/01/2025
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