Individual
DR. JON FRANCIS KNICKREHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
12511 WORLD PLAZA LN BLDG 50, FORT MYERS, FL 33907-3991
(239) 939-2622
(239) 939-0151
Mailing address
10201 AVALON LAKE CIR, FORT MYERS, FL 33913
(239) 768-7171
(239) 939-0151
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DO-596
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
276018500
—
FL
01
—
56478
BC BS FL
—
01
—
P00343579
RAILROAD MEDICARE
FL
Enumeration date
01/04/2006
Last updated
02/27/2013
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