Healthcare Provider Details
I. General information
NPI: 1790877579
Provider Name (Legal Business Name): RHONDA M. KESSLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/29/2006
Last Update Date: 11/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16114 WATERLEAF LN
FORT MYERS FL
33908-3120
US
IV. Provider business mailing address
16114 WATERLEAF LN
FORT MYERS FL
33908-3120
US
V. Phone/Fax
- Phone: 239-689-3934
- Fax: 239-689-3934
- Phone: 239-689-3934
- Fax: 239-689-3934
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085P0229X |
| Taxonomy | Pediatric Radiology Physician |
| License Number | ME32447 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: