Individual
MYLISSA PERSONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4130 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-9207
(941) 727-7100
(941) 787-7101
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9107484
FL
Other
Enumeration date
09/30/2013
Last updated
01/10/2024
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