Healthcare Provider Details

I. General information

NPI: 1558559013
Provider Name (Legal Business Name): CHRISTINA EVERSWICK ESPINETA PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2007
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11181 HEALTH PARK BLVD STE 3000
NAPLES FL
34110-5743
US

IV. Provider business mailing address

2675 WINKLER AVE FL 2
FORT MYERS FL
33901-9342
US

V. Phone/Fax

Practice location:
  • Phone: 239-566-1888
  • Fax: 239-430-5559
Mailing address:
  • Phone: 877-856-3774
  • Fax: 239-599-2612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9104322
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: