MEDICARE: RASMUSSEN FAMILY DENTAL NORTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)
2	122300000X	Dentist

General Provider Information

NPI Number	:	1437010246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RASMUSSEN FAMILY DENTAL NORTH LLC

Provider Business Mailing Address
First Line	:	17968 N TAMIAMI TRL STE 165
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-1418
Country	:	US
Telephone Number	:	239-731-0084
Fax Number	:

Provider Business Practice Location Address
First Line	:	17968 N TAMIAMI TRL STE 165
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-1418
Country	:	US
Telephone Number	:	239-731-0084
Fax Number	:

Authorized Official
Title or Position	:	DR.
Name	:	DR. ANDREA MARIE PARSONS
Credential	:
Telephone Number	:	239-731-0084

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	03/04/2026

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