JESSICA A BLACK (NPI# 1699178582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699178582 |
| Entity Type | Individual |
| Full Name | JESSICA A BLACK |
| Credential | PA-C |
| Practice Address |
10967 Lake Underhill Rd Suite 122 Orlando FL 32825-4457 |
| Practice Telephone | 4072823131 |
| Mailing Telephone | 4072823131 |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2020-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9108103 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992311120 | Jessica Ellen Black | Nutritionist | 1239 Liberty St Apt 225, El Cerrito, CA 94530-2347 | 2020-09-22 |
| 1417580234 | Jessica Black | Technician | 640 May St, Harlan, KY 40831-1628 | 2020-02-20 |
| 1881244374 | Jessica G Black | Physical Medicine & Rehabilitation | 10300 Courthouse Rd, Chesterfield, VA 23832 | 2019-09-17 |
| 1851894547 | Jessica J Black | Psychologist | 225 Humphrey Rd Ste 4, Greensburg, PA 15601-4571 | 2018-03-09 |
| 1619482569 | Jessica Ann Black | Massage Therapist | 3161 E Palmer Wasilla Hwy Ste 1, Wasilla, AK 99654-7271 | 2017-12-13 |
| 1104187764 | Jessica Lauren Black | Dental Hygienist | 1413 Gold Buckle Ct, Redlands, CA 92374-2790 | 2012-05-30 |
| 1366676439 | Jessica Donze Black | Dietitian, Registered | 230 N Granada St, Arlington, VA 22203-1322 | 2009-05-05 |
| 1134305337 | Jessica K Black | Naturopath | 330 Se Baker St, Unit 3, Mcminnville, OR 97128-6038 | 2008-01-17 |
| 1336102607 | Jessica Anne Black | Occupational Therapist | 9302 N Meridian St Ste 190, Indianapolis, IN 46260-1818 | 2006-04-08 |
| 1902403488 | Jessica Laurel Black | Case Manager/Care Coordinator | 22001 Fairmount Blvd, Cleveland, OH 44118-4897 | 2020-10-07 |
| Street Address |
10967 LAKE UNDERHILL RD SUITE 122 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32825-4457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629079413 | Adriana Garcia | Nurse Practitioner | 10967 Lake Underhill Rd, Ste117, Orlando, FL 32825-4457 | 2005-08-03 |
| 1376999227 | Zilan Hu | Acupuncturist | 10967 Lake Underhill Rd, Ste 135, Orlando, FL 32825-4455 | 2016-05-10 |
| 1033596119 | Margaret M Cornwell | Counselor | 10967 Lake Underhill Rd, Suite 113, Orlando, FL 32825-4457 | 2015-04-28 |
| 1245648500 | Light of Life, Inc. | Home Health | 10967 Lake Underhill Rd, Suite 112, Orlando, FL 32825-4457 | 2014-07-30 |
| 1861803355 | Lillian Rivera-lakhan | Counselor | 10967 Lake Underhill Rd, Suite 113, Orlando, FL 32825-4457 | 2014-05-19 |
| 1871910737 | Janel Diehr | Nurse Practitioner | 10967 Lake Underhill Rd, Suite 148, Orlando, FL 32825-4457 | 2014-03-27 |
| 1396161121 | Orlando Behavioral Healthcare | Counselor | 10967 Lake Underhill Rd, Suite 113, Orlando, FL 32825-4457 | 2014-03-18 |
| 1770870628 | Legacy Park Discount Pharmacy | Pharmacy | 10967 Lake Underhill Rd, Orlando, FL 32825-4457 | 2011-06-29 |
| 1790930865 | Larry D Pinkus Rpt Ap LLC | Physical Therapist | 10967 Lake Underhill Rd, Suite#109, Orlando, FL 32825-4457 | 2008-11-17 |
| 1528285749 | Comprehensive Neurology Clinic Pa | Psychiatry & Neurology | 10967 Lake Underhill Rd, Suite 148, Orlando, FL 32825-4457 | 2007-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881255404 | Planes Dental East Orlando | Clinic/Center | 275 S Chickasaw Trail, Suite 2, Orlando, FL 32825 | 2019-06-25 |
| 1649837550 | Jessica Rivera | Social Worker | 10600 Bloomfield Drive, Apt 918, Orlando, FL 32825 | 2019-05-27 |
| 1326526708 | Total Family Care LLC | Family Medicine | 106 North Dean Road, Suite 1, Orlando, FL 32825 | 2018-07-30 |
| 1285121772 | Neurological Health Associates, L.L.C. | Psychiatry & Neurology | 11602 Lake Underhill Rd., Suite 104, Orlando, FL 32825 | 2018-04-19 |
| 1336636075 | Vijaya Laxmi Telu | Nurse Practitioner | 100 North Dean Rd Suite 101, Orlando, FL 32825 | 2018-04-18 |
| 1740795053 | Anna Louise Morris | Specialist/Technologist | 10719 Fairhaven Way, Orlando, FL 32825 | 2017-12-08 |
| 1568973352 | Darrenn G Cadet | Behavior Technician | 11121 Tortuga Bnd, Orlando, FL 32825 | 2017-10-19 |
| 1265942072 | Raquel B Saliba | Physical Therapist | 250 South Chickasaw Trail, Orlando, FL 32825 | 2017-10-06 |
| 1528585890 | Vreny Tatyana Gonzalez-casas | Behavior Technician | 3206 Mattson Dr, Orlando, FL 32825 | 2017-08-27 |
| 1184147803 | Alexandra Grace Mcmanus | Social Worker | 11258 Point Sylvan Circle, Orlando, FL 32825 | 2017-07-25 |
| Find all providers in zip 32825 | ||||
| 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 |
|---|---|---|---|---|
| 1881295525 | Asahel Romero | Physician Assistant | 13228 Canna Lily Dr, Orlando, FL 32824-5067 | 2020-11-07 |
| 1609473594 | Arianna Piza Cueva | Physician Assistant | 1617 Lake Baldwin Ln, Orlando, FL 32814-6745 | 2020-10-05 |
| 1679189153 | Lynnzie Marie Kipp | Physician Assistant | 6427 Westwood Blvd Unit 100, Orlando, FL 32821-8311 | 2020-09-20 |
| 1396368189 | Katharine Mcmanus | Physician Assistant | 6137 Jibway Ct, Orlando, FL 32807-2909 | 2020-05-27 |
| 1124651328 | Kayleigh E Hunt | Physician Assistant | 86 W Copeland Dr, Orlando, FL 32806-2002 | 2020-02-16 |
| 1326679093 | Hae Jeung | Physician Assistant | 1713 Circe Lake Ct, Orlando, FL 32826-4645 | 2020-01-30 |
| 1902445844 | Christina Pagan | Physician Assistant | 2014 S Orange Ave # 200b, Orlando, FL 32806-3069 | 2019-12-23 |
| 1154969335 | Shahed Hmeidan | Physician Assistant | 2624 Clementon Park Ct, Orlando, FL 32835-6160 | 2019-12-18 |
| 1609414143 | Amber Grimm | Physician Assistant | 2144 Bristol Grande Way, Orlando, FL 32820-2781 | 2019-12-16 |
| 1255976213 | Katherine Mary Vanhove | Physician Assistant | 1310 E Esther St, Orlando, FL 32806-4128 | 2019-11-14 |
| Find all providers in ORLANDO | ||||
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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.