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NPI Code Detail

MEDICARE: PAYTON EBERLING

MEDICARE: PAYTON EBERLING
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
1363A00000XPhysician AssistantPA9120702FL

General Provider Information

NPI Number : 1548021298
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAYTON EBERLING
Provider Business Mailing Address
First Line : 2675 WINKLER AVE STE 200
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9328
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2450 TAMIAMI TRL STE A
Second Line :
City : PORT CHARLOTTE
State : FL
Zip : 33952-3922
Country : US
Telephone Number : 941-624-2704
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2024
Last Update Date : 04/20/2026

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Directions to “ PAYTON EBERLING ” Practice Location

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