Healthcare Provider Details

I. General information

NPI: 1003878877
Provider Name (Legal Business Name): WESLEY H FAUNCE III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13685 DOCTORS WAY STE 350
FORT MYERS FL
33912-4347
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-3800
  • Fax: 239-343-3993
Mailing address:
  • Phone: 239-343-3800
  • Fax: 239-343-3993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME74121
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: