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Individual

GEORGE REGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.C.

Contact information

Practice address
14451 ALICO RD, FORT MYERS, FL 33913
(239) 482-4567
Mailing address
14451 ALICO RD, FORT MYERS, FL 33913-8247
(239) 482-4567

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101322
FL
363AS0400X
Surgical Physician Assistant
PA9101322
FL

Other

Enumeration date
05/17/2006
Last updated
05/13/2010
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