MR. ALEX RICHARD REYNOLDS (NPI# 1043784432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043784432 |
| Entity Type | Individual |
| Full Name | MR. ALEX RICHARD REYNOLDS |
| Credential | PA-C |
| Practice Address |
2700 Creekside Ln Suit 101 Fort Myers FL 33913 |
| Mailing Address |
12700 Creekside Ln Ste 101 Fort Myers FL 33919-3356 |
| Practice Telephone | 2394320774 |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2019-01-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2700 CREEKSIDE LN SUIT 101 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467079368 | Fq0014 | Clinic/Center | 11930 Fairway Lakes Dr, Ste 103, Fort Myers, FL 33913 | 2020-06-26 |
| 1386272334 | Chrysallis Wellness Center Inc | Counselor | 11932 Faiway Lakes, Fort Myers, FL 33913 | 2020-03-27 |
| 1811459399 | Kelly Christine Reynolds | Student in an Organized Health Care Education/Training Program | 11750 Rosemount Drive, Fort Myers, FL 33913 | 2019-04-03 |
| 1881196541 | Kara Seanor | Counselor | 12575 Stone Tower Loop, Fort Myers, FL 33913 | 2018-03-08 |
| 1063951515 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 13121 Paul J. Doherty Pkwy, Fort Myers, FL 33913 | 2017-02-16 |
| 1518337492 | Barry K Butler P.a. | Internal Medicine | 10708 Bradbury Way, Fort Myers, FL 33913 | 2015-10-05 |
| 1811322886 | Bernard Timothy Renner | Pharmacist | 10000 Gulf Coast Town Center Drive, Ft. Myers, FL 33913 | 2013-09-10 |
| 1831531979 | Debra Anne Channer | Pharmacist | 12550 Professional Park Drive Unit 1, Walgreens Co., Ft. Myers, FL 33913 | 2013-07-17 |
| 1144572249 | Victoria Sydeco Tayengco-maisog | Pediatrics | 9304 Trieste Drive, Fort Myers, FL 33913 | 2012-10-12 |
| 1578848164 | David L. Lovell | Pharmacist | 10088 Gulf Center Drive, Costco Pharmacy 0621, Ft Myers, FL 33913 | 2011-10-15 |
| Find all providers in zip 33913 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013261197 | Jamison Dicus | Physician Assistant | 7370 College Pkwy Ste 206, Fort Myers, FL 33907-5558 | 2012-10-29 |
| 1902102445 | Alisa K Romero | Physician Assistant | 12700 Creekside Lane, Suite 101, Fort Myers, FL 33919-3356 | 2011-02-01 |
| 1851691653 | Leslie F Naoom | Physician Assistant | 2531 Cleveland Ave 1, Fort Myers, FL 33901-4900 | 2010-10-26 |
| 1942327366 | Caroline N. Saleeby | Physician Assistant | 2531 Cleveland Ave Ste 1, Fort Myers, FL 33901-4900 | 2007-03-22 |
| 1295815298 | Christina Marie Brushaber | Physician Assistant | 5216 Clayton Ct, Fort Myers, FL 33907-2116 | 2006-10-16 |
| 1952337636 | Joseph Deily Iv | Physician Assistant | 9981 S Healthpark Dr Ste 120, Fort Myers, FL 33908 | 2006-06-24 |
| 1689640732 | Ann V Brock | Physician Assistant | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2006-02-28 |
| 1326671553 | Kelly Elizabeth Carney | Physician Assistant | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2020-02-17 |
| 1114440534 | Aleisha Nicole Rees | Physician Assistant | 6821 Palisades Park Ct Ste 1, Fort Myers, FL 33912-7131 | 2017-07-18 |
| 1427586577 | Tilia Gonzalez | Physician Assistant | 2531 Cleveland Ave Ste 1, Fort Myers, FL 33901-4900 | 2017-06-01 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33913 |
Please comment or provide details below to improve the information on MR. ALEX RICHARD REYNOLDS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.