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NPI Code Detail

MEDICARE: JESSIE LYNN HOLLINGER P.A.

MEDICARE: JESSIE LYNN HOLLINGER P.A.
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 AssistantC0003672MD
2363A00000XPhysician AssistantPA9109449FL

Other Identifiers

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

General Provider Information

NPI Number : 1871775585
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSIE LYNN HOLLINGER P.A.
Provider Business Mailing Address
First Line : 2675 WINKLER AVE FL 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 877-856-3774
Fax Number :
Provider Business Practice Location Address
First Line : 9520 BONITA BEACH RD SE
Second Line :
City : BONITA SPRINGS
State : FL
Zip : 34135-4517
Country : US
Telephone Number : 239-319-2195
Fax Number : 239-319-2194
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2007
Last Update Date : 01/03/2024

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