Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bethany Danielle Wisniewski, PA-C

Individual provider Physician Assistant · NPI 1619693702

Bethany Danielle Wisniewski, PA-C is a Physician Assistant in Fort Myers, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6150 Diamond Centre Ct Unit 1200
Fort Myers, FL 33912-7135
Phone: (239) 344-9786
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1995 E Oakland Park Blvd Ste 310, Fort Lauderdale, FL 33306-1138 — (954) 791-6146

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9116636 (FL)
Physician Assistant Taxonomy 363A00000X · Licence PA9116636 (FL)

Record details

NPI number1619693702
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 19, 2022
Last updated in NPPESFebruary 13, 2025
Certification dateFebruary 13, 2025

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