Provider Demographics
NPI:1760457956
Name:ESCHEDOR, JONATHAN F (ARNP)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:F
Last Name:ESCHEDOR
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:7335 GLADIOLUS DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-5101
Practice Address - Country:US
Practice Address - Phone:239-689-6677
Practice Address - Fax:239-939-0223
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9228334363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY082SOtherBCBS OF FL
FL8003613OtherCIGNA
FLP1013128OtherFREEDOM
FLP01262758OtherRAILROAD MCR
FLP958851OtherOPTIMUM
FL7739721OtherAETNA
FLY0825VMedicare PIN
FL7739721OtherAETNA
FLP958851OtherOPTIMUM