Individual
MR. JOHN PETER KMETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3033 WINKLER AVE UNIT 100, FORT MYERS, FL 33916-9523
(239) 277-7070
(239) 277-7071
Mailing address
3033 WINKLER AVE UNIT 100, FORT MYERS, FL 33916-9523
(239) 277-7070
(239) 277-7071
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA1731
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065642900
—
FL
01
—
1902843352
TRICARE
FL
01
—
3464527
CIGNA
FL
01
—
36291
BCBS
FL
01
—
9423471
AETNA
FL
01
—
PA0001731
PA LICENSE
FL
Enumeration date
06/01/2006
Last updated
11/29/2018
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