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General NPI Number Information
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NPI Number | 1669761243
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Entity Type | Individual
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Provider Name | JONATHAN DAVID EBERHARDT CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 03/20/2026
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Provider Practice Location Address
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Address Line | 10825 DENNINGTON RD
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City | FORT MYERS
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State | FL
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Zip | 33913-8568
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Country | US
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Telephone | 309-696-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 10825 DENNINGTON RD
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City | FORT MYERS
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State | FL
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Zip | 33913-8568
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Country | US
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Telephone | 309-696-5880
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Fax | 866-665-2702
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN9268926
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License Number State | FL
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