Individual
J. ROBERT SOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3920 MICHIGAN AVE, FORT MYERS, FL 33916-2205
(239) 332-9501
(239) 332-9553
Mailing address
3920 MICHIGAN AVE, FORT MYERS, FL 33916-2205
(239) 332-9501
(239) 332-9553
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1641
FL
Other
Enumeration date
08/09/2006
Last updated
07/09/2007
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