Individual
JACK KOBURGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
636 DEL PRADO BLVD S, CAPE CORAL, FL 33990-2668
(239) 424-3513
Mailing address
6796 SMOKERISE DR, MACCLENNY, FL 32063-5256
(904) 312-2297
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9120347
FL
Other
Enumeration date
06/24/2025
Last updated
06/24/2025
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