MEDICARE: JONATHAN F. ESCHEDOR ARNP

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	363L00000X	Nurse Practitioner	ARNP9228334	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Y082S	OTHER	FL	BCBS OF FL
2	8003613	OTHER	FL	CIGNA
3	P1013128	OTHER	FL	FREEDOM
4	P01262758	OTHER	FL	RAILROAD MCR
5	P958851	OTHER	FL	OPTIMUM
6	7739721	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1760457956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN F. ESCHEDOR ARNP

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	ATTN: PAYER CONTRACTING & RELATIONS
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	7335 GLADIOLUS DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-5101
Country	:	US
Telephone Number	:	239-689-6677
Fax Number	:	239-939-0223

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	01/16/2015

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