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General NPI Number Information
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NPI Number | 1164569125
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Entity Type | Individual
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Provider Name | JOSE M ALMANZAR PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 3164 PALM BEACH BLVD STE 104-D
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City | FORT MYERS
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State | FL
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Zip | 33916-1579
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Country | US
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Telephone | 239-590-8399
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Fax | 239-264-4982
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Provider Business Mailing Address
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Address Line | 3164 PALM BEACH BLVD STE 104-D
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City | FORT MYERS
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State | FL
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Zip | 33916-1579
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Country | US
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Telephone | 239-590-8399
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Fax | 239-264-4982
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3284
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 3284
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA3284
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License Number State | FL
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