Healthcare Provider Details

I. General information

NPI: 1114978715
Provider Name (Legal Business Name): JOHN CONREY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN CONREY M.D.

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14560 HOPE CENTER LOOP
FORT MYERS FL
33912-4711
US

IV. Provider business mailing address

14560 HOPE CENTER LOOP
FORT MYERS FL
33912-4711
US

V. Phone/Fax

Practice location:
  • Phone: 239-939-0999
  • Fax: 239-939-1070
Mailing address:
  • Phone: 239-939-0999
  • Fax: 239-939-1070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME 76841
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME76841
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: