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NPI Code Detail

MEDICARE: JEFFREY RONALD SEMAK ARNP

MEDICARE: JEFFREY RONALD SEMAK ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner797AK

General Provider Information

NPI Number : 1952341299
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY RONALD SEMAK ARNP
Provider Business Mailing Address
First Line : PO BOX 2147
Second Line :
City : FORT MYERS
State : FL
Zip : 33902-2147
Country : US
Telephone Number : 239-424-1400
Fax Number : 239-424-1421
Provider Business Practice Location Address
First Line : 9131 COLLEGE POINTE CT
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-3245
Country : US
Telephone Number : 907-729-4955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 01/02/2013

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