Provider Demographics
NPI:1659340123
Name:FINCH, FRANK M (PA)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:M
Last Name:FINCH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12338 2ND ST
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-4808
Mailing Address - Country:US
Mailing Address - Phone:239-850-7519
Mailing Address - Fax:
Practice Address - Street 1:2718 LEE BLVD
Practice Address - Street 2:STE B
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-1537
Practice Address - Country:US
Practice Address - Phone:239-274-8005
Practice Address - Fax:239-275-8005
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103119363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP001888977OtherRAILROAD MEDICARE
FL287936OtherWELLCARE
FL292005100Medicaid
FL287936OtherWELLCARE