Healthcare Provider Details

I. General information

NPI: 1871058438
Provider Name (Legal Business Name): COURTNEY MICHELLE TOBOL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2019
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 CAPE CORAL PKWY E STE 202
CAPE CORAL FL
33904-8522
US

IV. Provider business mailing address

12730 NEW BRITTANY BLVD STE 602
FORT MYERS FL
33907-4690
US

V. Phone/Fax

Practice location:
  • Phone: 239-541-4420
  • Fax: 239-468-7908
Mailing address:
  • Phone: 239-275-5522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9444923
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: