JENNIFER L MISECHOK (NPI# 1619952934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619952934 |
| Entity Type | Individual |
| Full Name | JENNIFER L MISECHOK |
| Credential | P.A.-C |
| Practice Address |
10 Pasadena Ave N St Petersburg FL 33710-8330 |
| Mailing Address |
Po Box 40658 St Petersburg FL 33743-0658 |
| Practice Telephone | 7273812500 |
| Practice Fax Number | 7273438746 |
| Mailing Telephone | 7273812500 |
| Mailing Fax Number | 7273438746 |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2010-12-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9103594 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | LICENSE | PA9103594 | 01 |
| Street Address |
10 PASADENA AVE N |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33710-8330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275532343 | Hogan G Yi | Orthopaedic Surgery | 10 Pasadena Ave N, St Petersburg, FL 33710-8330 | 2005-07-20 |
| 1619476512 | Kasey Lee Murray | Physician Assistant | 10 Pasadena Ave N, St Petersburg, FL 33710-8330 | 2018-02-06 |
| 1497172498 | Sean Croteau | Physician Assistant | 10 Pasadena Ave N, St Petersburg, FL 33710-8330 | 2014-03-27 |
| 1003949389 | Hogan G. Yi, Md, Pa | Specialist | 10 Pasadena Ave N, St Petersburg, FL 33710-8330 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615812 | Bay Vision Inc | Optometrist | 6951 22nd Ave North, St. Petersburg, FL 33710 | 2020-10-05 |
| 1821566845 | Harish J. Patel, Md | Non-Pharmacy Dispensing Site | 6449 38th Avenue North, Suite B3, Saint Petersburg, FL 33710 | 2018-11-07 |
| 1659860708 | Lydia M Gomez | Physical Therapist | 6775 Crosswinds Dr. N, Saint Petersburg, FL 33710 | 2018-05-04 |
| 1619498169 | Tiffiny C Rudkin | Massage Therapist | 3039 - 49th St. N., St. Petersburg, FL 33710 | 2017-07-05 |
| 1114456480 | Roberto Macedo Dentistry LLC | Dentist | 7801 38th Ave North, St. Petersburg, FL 33710 | 2017-06-08 |
| 1528429495 | Frank Michael Massotto Jr. | Nurse Practitioner | 3251 66th St. North, St Petersburg, FL 33710 | 2016-03-18 |
| 1235522889 | Toby Weinman Assisted Living Residence | Assisted Living Facility | 240 59th St N, St Petersburg, FL 33710 | 2015-03-06 |
| 1821415951 | Ryan Troup | Physician Assistant | 603 - 7th St. S, Suite 360, Emergency Physicians of Saint Petersburg, Saint Petersburg, FL 33710 | 2014-03-26 |
| 1629491600 | Garett Janes Sears | Psychologist | 1913 Tyrone Blvd, St. Petersburg, FL 33710 | 2014-01-28 |
| 1912331943 | Solimar Jimenez Diaz | Obstetrics & Gynecology | 6450 38th Ave N Ste 200, St Petersburg, FL 33710 | 2013-08-27 |
| Find all providers in zip 33710 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972168052 | Carlee Freed | Physician Assistant | 2191 9th Ave N Ste 270, St Petersburg, FL 33713-7149 | 2019-05-05 |
| 1558633602 | Jennifer Michelle Boyd | Physician Assistant | 636 16th Ave Ne, St Petersburg, FL 33704-4719 | 2012-02-06 |
| 1457511685 | Sheila Faye Zimmardi | Physician Assistant | 625 6th Ave S Ste 450, St Petersburg, FL 33701-4629 | 2008-06-11 |
| 1215987029 | Claudia B Botero | Physician Assistant | 239 2nd Ave S, Suite 200, St Petersburg, FL 33701-4333 | 2006-05-11 |
| 1700875960 | Angela Bowersock | Physician Assistant | 601 7th St S Ste 205, St Petersburg, FL 33701-4708 | 2005-10-19 |
| 1962499723 | Jennifer Mary Broderick | Physician Assistant | 960 7th Ave N, St Petersburg, FL 33705-1347 | 2005-10-05 |
| 1174177927 | Us Medical Solutions, LLC | Physician Assistant | 871 Ibis Walk Pl N Unit 3204, St Petersburg, FL 33716-3857 | 2019-07-30 |
| 1184282907 | Mark Daicoff | Physician Assistant | 4600 4th St N, St Petersburg, FL 33703-3802 | 2019-06-05 |
| 1760045272 | Savannah Kelly Poor | Physician Assistant | 625 6th Ave S Ste 450, St Petersburg, FL 33701-4629 | 2019-04-19 |
| 1588138499 | Chandler Melton | Physician Assistant | 625 6th Ave S Ste 450, St Petersburg, FL 33701-4629 | 2019-01-14 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33710 |
Please comment or provide details below to improve the information on JENNIFER L MISECHOK.
| 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.