Basic Information
| Provider Information | |||||||||
| NPI: | 1265669311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASAPH | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2160 COLONIAL BLVD | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339071410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2399317342 | ||||||||
| FaxNumber: | 2399317385 | ||||||||
| Practice Location | |||||||||
| Address1: | 1505 TAMIAMI TRL S STE 405 | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342855547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9414977700 | ||||||||
| FaxNumber: | 9414933703 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2009 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA9104088 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | P1012951 | 01 | FL | FREEDOM | OTHER | 009563900 | 05 | FL | MEDICAID | 7484918 | 01 | FL | CIGNA | OTHER | P01220356 | 01 | FL | RR MEDICARE | OTHER | Y0J2V | 01 | FL | BCBS OF FL | OTHER | Y0J2V | 01 | FL | BCBS | OTHER | 4889866 | 01 | FL | AETNA | OTHER | 1218066 | 01 | FL | WELLCARE | OTHER | P01220356 | 01 | FL | RAILROAD MCR | OTHER | P1012951 | 01 | FL | FREEDOM HEALTH | OTHER | P952025 | 01 | FL | OPTIMUM | OTHER | 398534 | 01 | FL | AVMED | OTHER | P01807405 | 01 | FL | CLEAR HEALTH ALLIANCE | OTHER |