Provider Demographics
NPI:1679518922
Name:ENRIGHT, ROBERT ANTHONY (PA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANTHONY
Last Name:ENRIGHT
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:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-424-2030
Mailing Address - Fax:239-343-4117
Practice Address - Street 1:507 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2618
Practice Address - Country:US
Practice Address - Phone:239-424-2030
Practice Address - Fax:239-343-4117
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103375363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010431800Medicaid
FLP1019779OtherFREEDOM
FLP958305OtherOPTIMUM
FL1225331OtherWELLCARE
FL9662679OtherAETNA
FLP01220222OtherRAILROAD MCR
FL398583OtherAVMED
FL6620351OtherCIGNA
FL6620351OtherCIGNA
FL9662679OtherAETNA
FLS69992Medicare UPIN
FLU6282VMedicare PIN