Healthcare Provider Details

I. General information

NPI: 1568344117
Provider Name (Legal Business Name): YVONNE MEDVECKY RODRIGUEZ FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4771 S CLEVELAND AVE
FORT MYERS FL
33907-1317
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-9800
  • Fax:
Mailing address:
  • Phone: 239-343-9800
  • Fax: 239-343-9848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11040604
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: