DAVID VANAVER LYSKOWSKI (NPI# 1750789558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750789558 |
| Entity Type | Individual |
| Full Name | DAVID VANAVER LYSKOWSKI |
| Credential | PA-C |
| Practice Address |
13782 Plantation Rd Building 4, Suite 201 Fort Myers FL 33912-4462 |
| Mailing Address |
Po Box 2147 Fort Myers FL 33902-2147 |
| Practice Telephone | 2393431105 |
| Practice Fax Number | 2393431106 |
| Mailing Telephone | 2393431105 |
| Mailing Fax Number | 2393431106 |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2020-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
9107603 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 014097500 | 05 | |
| FL | TYPE 2 NPI | 1346670130 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13340 Metro Pkwy Ste 400, Fort Myers, FL 339664818 | 2393431105 | 2393431106 |
| Street Address |
13782 PLANTATION RD BUILDING 4, SUITE 201 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33912-4462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376544775 | Joseph Hobson | Family Medicine | 13782 Plantation Rd, Suite 201, Fort Myers, FL 33912-4462 | 2005-08-09 |
| 1447586938 | Pamela Margaret Ledward | Physician Assistant | 13782 Plantation Rd, Suite 201, Fort Myers, FL 33912-4462 | 2009-10-19 |
| 1336379478 | Eileen C De Grandis | Surgery | 13782 Plantation Rd, Fort Myers, FL 33912-4462 | 2009-07-23 |
| 1669667879 | Ira S Saunders | Physician Assistant | 13782 Plantation Rd, Suite 201, Fort Myers, FL 33912-4462 | 2007-09-11 |
| 1053378240 | Sunil Pammi | Internal Medicine | 13782 Plantation Rd, Building 4, Suite 201, Fort Myers, FL 33912-4462 | 2006-05-01 |
| 1154396661 | Christopher Alfonso Mallari | Physician Assistant | 13782 Plantation Rd, Building 4, Suite 201, Fort Myers, FL 33912-4462 | 2006-02-19 |
| 1528045747 | Brian Daniel Kurland | Surgery | 13782 Plantation Rd, Unit103, Fort Myers, FL 33912-4462 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134684814 | Performance Health Surgery Center | Clinic/Center | 9500 Gulf Research Lane, Fort Myers, FL 33912 | 2019-02-06 |
| 1609351899 | Voa Lee County Health Care Facility, Inc. | Skilled Nursing Facility | 14750 Hope Center Loop, Ft. Myers, FL 33912 | 2018-10-03 |
| 1245719954 | Lauren Grimes | Pharmacist | 13711 S Tamiami Trail, Fort Myers, FL 33912 | 2018-08-13 |
| 1972080828 | Solaris Rehab, LLC | Clinic/Center | 14001 Metro Parkway, Fort Myers, FL 33912 | 2018-07-24 |
| 1467943803 | Marie Veronica Scott | Nurse Practitioner | 14015 Danpak Loop, Fort Myers, FL 33912 | 2018-05-22 |
| 1952892291 | Daniels Modern Dentistry, Pa | Dentist | 6871 Daniels Parkway, Suite 100, Fort Myers, FL 33912 | 2018-05-22 |
| 1295258994 | Julie Ann Jakobi | Counselor | 18 Quanery Court, Fort Myers, FL 33912 | 2017-07-25 |
| 1205359908 | Maria Reyes | Developmental Therapist | 8961 Daniels Center Drive Suite 401, Fort Myers, FL 33912 | 2017-07-25 |
| 1669919288 | Darinka Ruiz | Social Worker | 961 Daniels Center Drive, Suite 401, Fort Myers, FL 33912 | 2017-01-20 |
| 1730622598 | Valerie Starnes | Nurse Practitioner | 13411 Parker Commons Blvd Ste 101, Fort Myers, FL 33912 | 2016-11-28 |
| Find all providers in zip 33912 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679981641 | Corbett Family Medical Center Plc | Physician Assistant | 4991 Royal Gulf Cir, Fort Myers, FL 33966-7006 | 2014-07-23 |
| 1437599438 | A&b Premier Medical Services | Physician Assistant | 10390 Washingtonia Palm Way Apt 4424, Fort Myers, FL 33966-7992 | 2013-07-05 |
| 1609118645 | Sunshine Mobile Medical Services, LLC | Physician Assistant | 2301 Harvard Ave, Fort Myers, FL 33907-4232 | 2013-03-16 |
| 1821272774 | Ashokkumar B Chaudhari | Physician Assistant | 6599 Plantation Preserve Cir N, Fort Myers, FL 33966-8366 | 2007-12-27 |
| 1982767745 | Elaine-maria Zafar | Physician Assistant | 8381 Riverwalk Park Blvd Ste 202, Fort Myers, FL 33919-8760 | 2006-12-19 |
| 1093707341 | Richard D Ornato | Physician Assistant | 9400 Gladiolus Dr, Suite 250, Fort Myers, FL 33908-6699 | 2005-08-22 |
| 1841841822 | Anisa Meghan Jallal | Physician Assistant | 7335 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2019-09-22 |
| 1275181265 | Rachel Michele Bautsch | Physician Assistant | 7335 Gladiolus Dr, Fort Myers, FL 33908-5101 | 2019-09-03 |
| 1447758818 | William Floyd Meyer | Physician Assistant | 11300 Lindbergh Blvd Ste 110, Fort Myers, FL 33913 | 2018-01-31 |
| 1902325681 | Jason Anthony Moore | Physician Assistant | 13861 Plantation Rd Ste 104, Fort Myers, FL 33912-4342 | 2017-09-14 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33912 |
Please comment or provide details below to improve the information on DAVID VANAVER LYSKOWSKI.
| 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.