DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. OTTO R MEDINILLA JR., PAC

Active Sole Proprietor

MR. OTTO R MEDINILLA JR., PAC is a Physician Assistant healthcare provider located in FORT MYERS, Florida. NPI 1649259540 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · FORT MYERS, FL

Registration Details

NPI Number
1649259540
Provider Type
Individual
Gender
Male
NPI Issued
Jan 10, 2006 (20.412043217399 yrs)
Last Updated
Dec 1, 2020
License
C50000198 (DE)
Sole Proprietor
Yes

Practice Information

Address
11300 LINDBERGH BLVD STE 115
FORT MYERS, FL, 339138827
Browse FL providers · Browse ZIP 33913
Phone
2392458600
Fax
2392458660
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in FORT MYERS, FL

Name Credential NPI
MATTHEW EDWARD MEAGHER PAC 1730185356
MR. JARED P. REISS PA-C 1558360206
PASQUALE JOHN DEFIORE PA-C 1063413458
CLAUDETTE F JACKSON PAC 1962494450
MS. KRISTIN J OVADAL PAC 1063407930
BARBARA J MAGGIANI PA-C 1942282546
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.