COLLEEN MCGONAGLE (NPI# 1699307389) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699307389 |
| Entity Type | Individual |
| Full Name | COLLEEN MCGONAGLE |
| Credential | PA-C |
| Practice Address |
12700 Creekside Ln Ste 101 Fort Myers FL 33919-3356 |
| Mailing Address |
3731 Sw 1st Ter Cape Coral FL 33991-7645 |
| Practice Telephone | 2396824194 |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2020-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 9113021 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12700 CREEKSIDE LN STE 101 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33919-3356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073145942 | Patricia June Briand | Registered Nurse | 4309 Mariner Way #307, Fort Myers, FL 33919 | 2020-02-10 |
| 1629556840 | The Onyx Counseling Center, LLC | Social Worker | 6361 Presidential Ct Ste 101, Fort Myers, FL 33919 | 2018-07-31 |
| 1366980187 | My Precious Kids Therapy Center Inc | Community/Behavioral Health | 4755 Summerlin Road, Suite #4, Fort Myers, FL 33919 | 2017-02-01 |
| 1811342397 | Kimberly Regenesis | Substance Abuse Rehabilitation Facility | 8695 College Parkway, Suite 2080, Ft Myers, FL 33919 | 2016-05-03 |
| 1689030207 | Balance for All, Inc. | Acupuncturist | 6238 Presidential Ct., Ste 6, Fort Myers, FL 33919 | 2016-01-12 |
| 1902275217 | Kelly Jean Overton | Physical Therapist | 6341 Whiskey Creek Drive, Fort Myers, FL 33919 | 2015-09-16 |
| 1508125311 | Charles Clark Dugan IIi | Chiropractor | 6309 Corporate Court, Suite 110, Fort Myers, FL 33919 | 2012-05-14 |
| 1659641231 | Dasha Bich Le | Pharmacist | 9629 Bay Harbor Cir., Apt. 201, Fort Myers, FL 33919 | 2012-01-12 |
| 1164792602 | Gail Lee Rathbun | Nurse Practitioner | 6311 S. Pointe Blvd., Fort Meyers, FL 33919 | 2011-12-30 |
| 1871878173 | Scott Kozlowski | Behavioral Analyst | 5335 Shalley Cir., Ft. Myers, FL 33919 | 2011-10-18 |
| Find all providers in zip 33919 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679360 | Samantha Lee Zavada | Physician Assistant | 9459 Silver Pine Loop, Fort Myers, FL 33967-5152 | 2020-11-07 |
| 1811597198 | Alexis Thraen | Physician Assistant | 4536 Winkler Ave Apt 204, Fort Myers, FL 33966-7013 | 2020-10-27 |
| 1265065247 | Marathon Health LLC | Physician Assistant | 1660 Electric Ln, Fort Myers, FL 33917-3946 | 2020-02-18 |
| 1710510813 | Noshaba Khaliq | Physician Assistant | 17549 Cherry Ridge Ln, Fort Myers, FL 33967-5138 | 2020-02-17 |
| 1922643238 | Abigail Christine Reed | Physician Assistant | 16230 Summerlin Rd Ste 213-218, Fort Myers, FL 33908-5768 | 2019-11-11 |
| 1245899756 | Aileen Fiallo | Physician Assistant | 4571 Colonial Blvd Ste 210, Fort Myers, FL 33966-1156 | 2019-06-08 |
| 1316422199 | Angelia Lynette Sakyi-agyekum | Physician Assistant | 8291 Dani Dr Ste 101a, Fort Myers, FL 33966-8009 | 2018-09-27 |
| 1225547029 | Irene Julian | Physician Assistant | 14090 Metropolis Ave Ste 102, Fort Myers, FL 33912-4451 | 2017-09-25 |
| 1134653827 | Matthew Jeremy Blakemore | Physician Assistant | 6150 Diamond Centre Ct Ste 1300, Fort Myers, FL 33912-4367 | 2017-04-19 |
| 1598206633 | Stina Rosanna Mckenna | Physician Assistant | 8381 Riverwalk Park Blvd Ste 201, Fort Myers, FL 33919-8760 | 2017-03-08 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33919 |
Please comment or provide details below to improve the information on COLLEEN MCGONAGLE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.