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NPI 1386360592

NPI 1386360592 : PAIGE BISHOP PA-C : FORT MYERS, FL

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General NPI Number Information
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    NPI Number           |    1386360592
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    Entity Type          |    Individual 
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    Provider Name        |    PAIGE BISHOP PA-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/19/2022
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    Last Update Date     |    05/07/2025
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Provider Practice Location Address
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    Address Line         |    12670 CREEKSIDE LN STE 202 
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    City                 |    FORT MYERS
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    State                |    FL
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    Zip                  |    33919-3370
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    Country              |    US
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    Telephone            |    239-482-2663
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    Fax                  |    239-482-7585
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Provider Business Mailing Address
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    Address Line         |    12670 CREEKSIDE LN 
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    City                 |    FORT MYERS
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    State                |    FL
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    Zip                  |    33919-3370
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    Country              |    US
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    Telephone            |    866-974-2673
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    Fax                  |    866-939-2673
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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        |    363AS0400X
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    Taxonomy Name        |    Surgical Physician Assistant
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    License Number       |    PA9116699
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    License Number State |    FL
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