Active NPI
Mark Anthony Eldridge, CAA
- Anesthesiologist Assistant
- Fort Myers, FL
National Provider Identifier
1902364714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- AA501
- Practice address
- 2776 Cleveland Ave
Fort Myers, FL 33901 - Phone
- (239) 343-2000
- NPI assigned
- Mar 11, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | AA501 | FL | Primary |
Addresses
Primary practice location
2776 Cleveland Ave
Fort Myers, FL 33901
Mailing address
3404 Davie Rd Apt 305
Davie, FL 33314-1628
Phone (786) 508-6307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AA501 | FL | MD | Anesthesiologist Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552262400000",
"number": "1902364714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3404 DAVIE RD APT 305",
"city": "DAVIE",
"state": "FL",
"postal_code": "333141628",
"telephone_number": "786-508-6307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2776 CLEVELAND AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33901",
"telephone_number": "239-343-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDRIDGE",
"first_name": "MARK",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"credential": "CAA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-11",
"last_updated": "2019-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "FL",
"license": "AA501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.