Provider Demographics
NPI:1265669311
Name:ASAPH, JAMES E (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:ASAPH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:2160 COLONIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1410
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:1505 TAMIAMI TRL S STE 405
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-5547
Practice Address - Country:US
Practice Address - Phone:941-497-7700
Practice Address - Fax:941-493-3703
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9104088363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP1012951OtherFREEDOM
FL009563900Medicaid
FL7484918OtherCIGNA
FLP01220356OtherRR MEDICARE
FLY0J2VOtherBCBS OF FL
FLY0J2VOtherBCBS
FL4889866OtherAETNA
FL1218066OtherWELLCARE
FLP01220356OtherRAILROAD MCR
FLP1012951OtherFREEDOM HEALTH
FLP952025OtherOPTIMUM
FL398534OtherAVMED
FLP01807405OtherCLEAR HEALTH ALLIANCE
FLP01807405OtherCLEAR HEALTH ALLIANCE
FLCB827ZMedicare PIN