Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Juan Carlos Ibarra Moreno, SA-C

Individual provider Surgical Assistant · NPI 1780126219

Juan Carlos Ibarra Moreno, SA-C is a Surgical Assistant in Fort Myers, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2016
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Practice location Address checks out

6150 Diamond Centre Ct Unit 1200
Fort Myers, FL 33912-7135
Phone: (239) 344-9786
Fax: (239) 344-9215
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X · Licence 13-514 (FL)

Record details

NPI number1780126219
Entity typeIndividual (Type 1)
GenderMale
Credentials SA-C
Sole proprietorYes
NPI enumeratedNovember 15, 2016
Last updated in NPPESApril 10, 2020
Certification dateApril 10, 2020

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