Individual
AMBER LATTRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13681 DOCTORS WAY, FORT MYERS, FL 33912-4300
(239) 343-1000
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-3292
(239) 343-3695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106139
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115105000
—
FL
Enumeration date
11/10/2011
Last updated
08/26/2022
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