JACK M BELLAFIORE (NPI# 1215991690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215991690 |
| Entity Type | Individual |
| Full Name | JACK M BELLAFIORE |
| Credential | PA-C |
| Practice Address |
1117 N Olive Ave Suite 202 West Palm Beach FL 33401-3520 |
| Practice Telephone | 5616554450 |
| Practice Fax Number | 5616554469 |
| Mailing Telephone | 5616554450 |
| Mailing Fax Number | 5616554469 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2008-11-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9102570 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 291679700 | 05 |
| Street Address |
1117 N OLIVE AVE SUITE 202 |
| City | WEST PALM BEACH |
| State | FL |
| Zip Code | 33401-3520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112149 | Medfund LLC | Clinic/Center | 1117 N Olive Ave, Ste 101, West Palm Beach, FL 33401-3520 | 2005-05-23 |
| 1770032153 | Redirenu Surgical Group, LLC | Clinic/Center | 1117 N Olive Ave, Unit 201, West Palm Beach, FL 33401-3520 | 2016-09-27 |
| 1174077630 | Kristen Schwencke | Nurse Practitioner | 1117 N Olive Ave, Ste. 203, West Palm Beach, FL 33401-3520 | 2016-08-12 |
| 1497177133 | Mark Sisko | Dentist | 1117 N Olive Ave, Suite 102, West Palm Beach, FL 33401-3520 | 2014-01-15 |
| 1174762843 | Gi Healthcare | Anesthesiology | 1117 N Olive Ave, Suite 201, West Palm Beach, FL 33401-3520 | 2009-02-19 |
| 1033357926 | A1 Imaging of West Palm Beach LLC | Clinic/Center | 1117 N Olive Ave, Suite 101, West Palm Beach, FL 33401-3520 | 2009-01-30 |
| 1336397066 | Digestive Center of The Palm Beaches | Internal Medicine | 1117 N Olive Ave, Suite 203, West Palm Beach, FL 33401-3520 | 2008-09-06 |
| 1720247760 | A1 Imaging of West Palm Beach LLC | Clinic/Center | 1117 N Olive Ave, Suite 101, West Palm Beach, FL 33401-3520 | 2008-06-05 |
| 1396914800 | Elliot Ellis | Internal Medicine | 1117 N Olive Ave, Suite 203, West Palm Beach, FL 33401-3520 | 2008-02-28 |
| 1467641860 | Mark Sisko Dds Pa | Dentist | 1117 N Olive Ave, Suite 102, West Palm Beach, FL 33401 | 2007-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598371882 | Curt David Miller | Nurse Practitioner | 5300 East Avenue West Palm Beach Fl, West Palm Beach, FL 33401 | 2020-09-22 |
| 1699338152 | Carly N Lupo | Social Worker | 700 S Rosemary Ave, Suite 204 Ofc 101, West Palm Beach, FL 33401 | 2019-04-19 |
| 1740752625 | Latasha Harper | Specialist | 512 N St, West Palm Beach, FL 33401 | 2018-12-17 |
| 1124595640 | Elin Nordegren | Counselor | 1555 Palm Beach Lakes Blvd Suite 1560, West Palm Beach, FL 33401 | 2018-11-02 |
| 1205318664 | Phanette Turene | Behavior Technician | 1720 N Congress Ave Apt B207, West Palm Beach, FL 33401 | 2018-09-02 |
| 1790277002 | Ashley Zarda | Developmental Therapist | 253 8th St, West Palm Beach, FL 33401 | 2018-06-01 |
| 1487162988 | Pinnacle Counseling Service Pllc | Social Worker | 1900 S Olive Avenue, West Palm Beach, FL 33401 | 2018-01-18 |
| 1245754027 | Patricia Caroscio | Dental Hygienist | 800 Clematis Street, West Palm Beach, FL 33401 | 2017-08-02 |
| 1255852562 | Dermnow Pa | Dermatology | 1500 N Flasler Dr #, 101, West Palm Beach, FL 33401 | 2017-06-28 |
| 1699204289 | Edward Gerardo Ortiz | Counselor | 1639 Forum Place Suite #7, West Palm Beach, West Palm Beach, FL 33401 | 2017-06-07 |
| Find all providers in zip 33401 | ||||
| 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 |
|---|---|---|---|---|
| 1326512617 | Fleura Cenatus | Physician Assistant | 1917 N Haverhill Rd Apt 1, West Palm Beach, FL 33417-4692 | 2019-01-19 |
| 1437635943 | Shanna Bhagan | Physician Assistant | 4500 N Flagler Dr Apt B16, West Palm Beach, FL 33407 | 2018-07-17 |
| 1073009353 | Kaitlyn Rose Green | Physician Assistant | 560 Village Blvd Suite #150, West Palm Beach, FL 33409 | 2018-07-10 |
| 1780187716 | Punam Gopal | Physician Assistant | 3507 Broadway, West Palm Beach, FL 33407-4841 | 2018-03-15 |
| 1932555323 | Zoilemma Acosta | Physician Assistant | 4232 Colt Ln, West Palm Beach, FL 33406-2936 | 2016-05-04 |
| 1528436649 | Farah Alli | Physician Assistant | 2007 Palm Bch Lk Blvd, West Palm Beach, FL 33409-6501 | 2015-09-05 |
| 1811238272 | Gioconda Alicia Boaz | Physician Assistant | 2685 Forest Hill Blvd, West Palm Beach, FL 33406-5930 | 2013-03-11 |
| 1932452158 | Joseph Radich | Physician Assistant | 1411 N Flagler Dr Ste 9000, West Palm Beach, FL 33401-3421 | 2012-10-25 |
| 1023380599 | Neesha R Patel | Physician Assistant | 2047 Palm Beach Lakes Blvd Ste 300, West Palm Beach, FL 33409-6500 | 2012-01-31 |
| 1255578761 | Bristol Dominguez | Physician Assistant | 717 Mcintosh St, West Palm Beach, FL 33405-3145 | 2009-01-21 |
| Find all providers in WEST PALM BEACH | ||||
| City | WEST PALM BEACH |
| Zip Code | 33401 |
Please comment or provide details below to improve the information on JACK M BELLAFIORE.
| 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.