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NPI Code Detail

MEDICARE: JANE J PHILLIPS PA

MEDICARE: JANE J PHILLIPS PA
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
1363A00000XPhysician AssistantPA3707FL

General Provider Information

NPI Number : 1982686697
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE J PHILLIPS PA
Provider Business Mailing Address
First Line : 316 DEL PRADO BLVD S
Second Line : STE. 201
City : CAPE CORAL
State : FL
Zip : 33990-1710
Country : US
Telephone Number : 239-829-7102
Fax Number : 239-829-7104
Provider Business Practice Location Address
First Line : 316 DEL PRADO BLVD S
Second Line : STE. 201
City : CAPE CORAL
State : FL
Zip : 33990-1710
Country : US
Telephone Number : 239-829-7102
Fax Number : 239-829-7104
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 04/02/2010

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Directions to “ JANE J PHILLIPS PA” Practice Location

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