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General NPI Number Information
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NPI Number | 1073453791
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Entity Type | Individual
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Provider Name | JENNIFER MAE GASS PHD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 2848 CENTER POINTE DR
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City | FORT MYERS
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State | FL
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Zip | 33916-9521
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Country | US
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Telephone | 239-318-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 15791 SAN ANTONIO CT
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City | FORT MYERS
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State | FL
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Zip | 33908-2444
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Country | US
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Telephone | 270-404-0764
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0205X
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Taxonomy Name | Ph.D. Medical Genetics Physician
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License Number | DI53057
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License Number State | FL
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