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General NPI Number Information
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NPI Number | 1568022523
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Entity Type | Individual
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Provider Name | KRYSTAL K CASANOVA ENCARNACION APRN.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2019
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 16230 SUMMERLIN RD STE 215
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City | FORT MYERS
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State | FL
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Zip | 33908-5769
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Country | US
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Telephone | 239-343-7474
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Fax | 239-343-4190
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-424-1500
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Fax | 239-424-1423
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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 | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | APRN11002846
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License Number State | FL
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