Individual
MARYSE FORTUNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12220 TOWNE LAKE DR STE 1, FORT MYERS, FL 33913-8021
(239) 433-6700
Mailing address
12220 TOWNE LAKE DR STE 1, FORT MYERS, FL 33913-8021
(239) 433-6700
(239) 433-6706
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
106S00000X
Behavior Technician
RBT-19-80282
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
FL
Enumeration date
06/27/2019
Last updated
12/18/2025
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