MEDICARE: MS. JENNIFER L. RICE 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	363A00000X	Physician Assistant	PA9105815	FL

General Provider Information

NPI Number	:	1841225083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER L. RICE PA-C

Provider Business Mailing Address
First Line	:	15051 S. TAMIAMI TRAIL
Second Line	:	SUITE 203
City	:	FORT MYERS
State	:	FL
Zip	:	33908
Country	:	US
Telephone Number	:	239-437-8810
Fax Number	:	239-313-2555

Provider Business Practice Location Address
First Line	:	23471 WALDEN CENTER DR STE 300
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	34134-5016
Country	:	US
Telephone Number	:	239-498-3376
Fax Number	:	239-498-3379

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/09/2019

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