MS. JEANETTE MARIE GLUCK (NPI# 1023072170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023072170 |
| Entity Type | Individual |
| Full Name | MS. JEANETTE MARIE GLUCK |
| Credential | PA-C |
| Practice Address |
5070 Minton Rd Nw Ste 3 Palm Bay FL 32907-1157 |
| Practice Telephone | 3217681600 |
| Practice Fax Number | 3212552361 |
| Mailing Telephone | 3217681600 |
| Mailing Fax Number | 3214350100 |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2020-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9103559 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FLORIDA BLUE | Y07HY | 01 |
| Street Address |
5070 MINTON RD NW STE 3 |
| City | PALM BAY |
| State | FL |
| Zip Code | 32907-1157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861015109 | Tyreak Albert Mclarty | Behavior Technician | 2180 Julian Ave Nw, Palm Bay, FL 32907 | 2020-05-21 |
| 1871073759 | Jessica Elizabeth Ford | Physical Therapist | 470 Malabar Rd Se Unit 102, Palm Bay, FL 32907 | 2018-08-20 |
| 1598264558 | Corey Williams | Case Management | 1850 Delki St. Nw, Palm Bay, FL 32907 | 2018-02-06 |
| 1386154904 | Lauren Nicole Meek | Social Worker | 550 Malabar Rd Sw Apt 202, Palm Bay, FL 32907 | 2017-10-10 |
| 1679002877 | Kandice Monique Hearns | Physical Therapy Assistant | 175 Ne Villa Nueva Ave, Palm Bay, FL 32907 | 2017-06-09 |
| 1780113076 | Caring Manor LLC | Assisted Living Facility | 1863 Edith St Ne, Palm Bay, FL 32907 | 2017-06-08 |
| 1467992107 | Enrique Martinez | Counselor | 1510 Studley Dr. Nw, Palm Bay, FL 32907 | 2017-02-28 |
| 1144776469 | Stephanie Ann Hoenig | Physical Therapy Assistant | 1155 Malabar Rd Se, Palm Bay, FL 32907 | 2016-08-28 |
| 1124471529 | K & S Tender Care 11 | Assisted Living Facility | 226 Abalone Road Ne, Palm Bay, FL 32907 | 2016-07-20 |
| 1235507781 | Jai Ho LLC | Specialist | 1663 Georgia Street, Suite 400, Palm Bay, FL 32907 | 2015-09-14 |
| Find all providers in zip 32907 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588289722 | Maria Alejandra Arango Rojas | Physician Assistant | 1421 Malabar Rd Ne Ste 200, Palm Bay, FL 32907-2559 | 2020-06-13 |
| 1053830760 | Bryan James Carey | Physician Assistant | 741 Dinner St Ne, Palm Bay, FL 32907-2034 | 2017-09-13 |
| 1861940421 | Megan Dennis | Physician Assistant | 1168 Kenmore St Nw, Palm Bay, FL 32907-9012 | 2016-09-13 |
| 1053594366 | Melinda Ann Cobb | Physician Assistant | 490 Centre Lake Dr Ne Ste 200, Palm Bay, FL 32907-1189 | 2007-12-10 |
| 1932114477 | Bernie Kaiman | Physician Assistant | 6100 Minton Rd, Suite 102, Palm Bay, FL 32907 | 2006-07-31 |
| 1265428288 | Maria L Fortington | Physician Assistant | 5070 Minton Rd Nw, Suite 5, Palm Bay, FL 32907-1157 | 2005-09-26 |
| 1548779580 | Samar Fawaz | Physician Assistant | 175 Villa Nueva Ave Ne, Palm Bay, FL 32907-2595 | 2017-09-21 |
| 1033592597 | Jessica Regan | Physician Assistant | 5270 Babcock St Ne Ste 1, Palm Bay, FL 32905-4616 | 2015-07-02 |
| 1427370469 | Martin Antony Fidelia | Physician Assistant | 1421 Malabar Rd Ne, Physicians Office Bldg #200, Palm Bay, FL 32907-2576 | 2010-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295525 | Asahel Romero | Physician Assistant | 13228 Canna Lily Dr, Orlando, FL 32824-5067 | 2020-11-07 |
| 1629679360 | Samantha Lee Zavada | Physician Assistant | 9459 Silver Pine Loop, Fort Myers, FL 33967-5152 | 2020-11-07 |
| 1235730177 | Emily Figueroa Vega | Physician Assistant | 1920 Nw 97th Ave, Coral Springs, FL 33071-5950 | 2020-11-06 |
| 1922609114 | Jeannine Castaneda Calderon | Physician Assistant | 816 Arbor Pointe Ave, Minneola, FL 34715-6052 | 2020-11-04 |
| 1962003178 | Mohammed Bilal Sheikh | Physician Assistant | 2920 Ne 207th St Ste 901, Miami, FL 33180-1444 | 2020-11-04 |
| 1891396131 | Whiplashmd, LLC | Physician Assistant | 940 Centre Cir Ste 1018, Altamonte Springs, FL 32714-7242 | 2020-11-03 |
| 1831799527 | Emily Vander Zee | Physician Assistant | 6680 Bennett Creek Dr Apt 213, Jacksonville, FL 32216-0018 | 2020-10-30 |
| 1245830314 | Jonathan V Korah | Physician Assistant | 6650 Corporate Center Pkwy Apt 1108, Jacksonville, FL 32216-8725 | 2020-10-28 |
| 1255931473 | Rachel Gavrielle Stahly | Physician Assistant | 11438 Emuness Rd, Jacksonville, FL 32218-4050 | 2020-10-27 |
| 1356941504 | Kelsey Alexandra Leon | Physician Assistant | 5033 W Laurel St, Tampa, FL 33607-3855 | 2020-10-27 |
| Find all providers with the same taxonomy | ||||
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| 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.