MEDICARE: MR. JARED P. REISS PA-C

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	363AM0700X	Medical Physician Assistant	PA3719	FL
2	363AS0400X	Surgical Physician Assistant	PA3719	FL
3	363A00000X	Physician Assistant	PA3719	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558360206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JARED P. REISS PA-C

Provider Business Mailing Address
First Line	:	1501 MCGREGOR RESERVE DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-9658
Country	:	US
Telephone Number	:	407-376-4976
Fax Number	:	321-421-0393

Provider Business Practice Location Address
First Line	:	4961 ROYAL GULF CIR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33966-7006
Country	:	US
Telephone Number	:	239-687-4015
Fax Number	:	321-421-0393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	01/05/2023

Similar Medicare Providers

1861460024 — MRS. LILIANA P DEFIORE RPT
Practice Location Address:

4968 ROYAL GULF CIR
FORT MYERS, FL
33966-7006

Practice Phone: 239-275-4411
Practice Fax: 239-275-6408

1275595159 — KEITH S. SUSKO M.D.
Practice Location Address:

4977 ROYAL GULF CIR
FORT MYERS, FL
33966-7006

Practice Phone: 239-226-0077
Practice Fax: 239-489-0077

1942223540 — MRS. JENNIFER PATRICIA VOLTZ M.S. CCC-SLP
Practice Location Address:

4997 ROYAL GULF CIRCLE
FORT MYERS, FL
33966-7006

Practice Phone: 239-313-5049
Practice Fax: 239-313-5712

1982762159 — ONE ON ONE REHAB INC
Practice Location Address:

4968 ROYAL GULF CIR , SUITE 102
FORT MYERS, FL
33966-7006

Practice Phone: 239-275-4411
Practice Fax: 239-275-6408

1134378938 — PAIN RELIEF AND PHYSICAL REHAB INC
Practice Location Address:

4977 ROYAL GULF CIR
FORT MYERS, FL
33966-7006

Practice Phone: 239-226-0077
Practice Fax: 239-489-0077

1578792339 — DR. SOORENA SADRI DPM
Practice Location Address:

4956 ROYAL GULF CIR
FORT MYERS, FL
33966-7006

Practice Phone: 239-850-2736
Practice Fax:

Directions to “ MR. JARED P. REISS PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.