MR. JUSTIN FENNER LETOURNEAU (NPI# 1861710923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861710923 |
| Entity Type | Individual |
| Full Name | MR. JUSTIN FENNER LETOURNEAU |
| Credential | PA-C |
| Practice Address |
5860 Ranch Lake Blvd Suite 200 Bradenton FL 34202-3708 |
| Mailing Address |
2110 58th St W Bradenton FL 34209-5660 |
| Practice Telephone | 9413888997 |
| Practice Fax Number | 9413065876 |
| Mailing Telephone | 9413888997 |
| Mailing Fax Number | 9413065876 |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2018-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9108503 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5860 RANCH LAKE BLVD SUITE 200 |
| City | BRADENTON |
| State | FL |
| Zip Code | 34202-3708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316948318 | Irwin Becker | Family Medicine | 5860 Ranch Lake Blvd, Suite 200, Bradenton, FL 34202-3708 | 2005-08-02 |
| 1114572856 | Nicole Kay | Family Medicine | 5860 Ranch Lake Blvd, Bradenton, FL 34202-3718 | 2019-08-08 |
| 1578916508 | Tara Johnson | Nurse Practitioner | 5860 Ranch Lake Blvd, Suite 200, Bradenton, FL 34202-3718 | 2016-07-14 |
| 1467838102 | Nalin LLC | Clinic/Center | 5860 Ranch Lake Blvd, Suite A, Bradenton, FL 34202-3708 | 2015-08-05 |
| 1417392697 | Joseph Weatherly | Family Medicine | 5860 Ranch Lake Blvd, Suite 200, Bradenton, FL 34202-3708 | 2013-05-01 |
| 1417236407 | Elizabeth Ann Timpe | Nurse Practitioner | 5860 Ranch Lake Blvd, Suite 200, Bradenton, FL 34202-3718 | 2011-08-09 |
| 1184889602 | Paul Seguin | Physical Therapist | 5860 Ranch Lake Blvd, Suite 102, Bradenton, FL 34202-3719 | 2008-07-24 |
| 1245409655 | Doris K Ramirez Nessetti | Obstetrics & Gynecology | 5860 Ranch Lake Blvd, Suite 200, Bradenton, FL 34202-3708 | 2008-02-29 |
| 1518152081 | Sanjeev Joseph | Physical Therapist | 5860 Ranch Lake Blvd, Suite A, Bradenton, FL 34202-3708 | 2007-09-07 |
| 1073669271 | Claudia Ann Enos-castillo | Nurse Practitioner | 5860 Ranch Lake Blvd, Suite 200, Bradenton, FL 34202-3718 | 2007-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730795857 | Kind Smiles Dental Health | Clinic/Center | 11155 State Road 70 E, Lakewood Ranch, FL 34202 | 2020-09-23 |
| 1881208494 | Abby Elizabeth Crews | Nurse Practitioner | 7534, Divot Loop, Bradenton, FL 34202 | 2020-09-01 |
| 1982220158 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 14605 Sr 70, Bradenton, FL 34202 | 2020-06-23 |
| 1871118380 | Alternative Psychiatry, LLC | Registered Nurse | 8788 Sr 70 E, Suite 101, Bradenton, FL 34202 | 2020-06-10 |
| 1528617651 | Bass Partners LLC | Behavioral Analyst | 20818 Parkstone Terrace, Lakewood Ranch, FL 34202 | 2019-09-11 |
| 1861049090 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 11521 Sr 70 East, Bradenton, FL 34202 | 2019-08-22 |
| 1205496171 | Bryan J Morgan Lwr Pa | Dentist | 11157 Sr70 E, Lakewood Ranch, FL 34202 | 2019-06-13 |
| 1023677358 | Taneshia Mcclendon | Nurse Practitioner | 6310 Health Park Way Ste 100, Lakewood Ranch, FL 34202 | 2019-06-11 |
| 1497231542 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 7325 University Pkwy, Lakewood Ranch, FL 34202 | 2018-07-12 |
| 1790273159 | Main Street Childrens Dentistry and Orthodontics of Lakewood Ranch Pll | Dentist | 11649 Sr 70 East, Suite 109, Bradenton, FL 34202 | 2018-05-01 |
| Find all providers in zip 34202 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548588262 | Michael John Dale | Physician Assistant | 6110 S.r. 70 East (53rd Ave), Bradenton, FL 34203 | 2010-05-05 |
| 1548463516 | Wanda Rivera | Physician Assistant | 3600 Lake Bayshore Dr Unit 502, Bradenton, FL 34205-9050 | 2007-06-07 |
| 1750416582 | Dominic Louis Sorrentino Jr. | Physician Assistant | 8648 E State Road 70, Bradenton, FL 34202-3785 | 2007-02-22 |
| 1295770816 | John E Darovec Jr. | Physician Assistant | 3649 Cortez Rd W, Bradenton, FL 34210-3106 | 2006-06-18 |
| 1003883299 | Patricia Anne Keefe | Physician Assistant | 4647 Manatee Avenue W, Bradenton, FL 34209-3816 | 2006-03-07 |
| 1063402006 | Roger Cordial | Physician Assistant | 315 75th St West, Pinnacle Urgent Care, Bradenton, FL 34209 | 2005-10-21 |
| 1184257255 | Erika Burbano | Physician Assistant | 1886 59th St W, Bradenton, FL 34209-4630 | 2020-02-18 |
| 1811539042 | Joseph Burke | Physician Assistant | 6110 State Road 70 E, Bradenton, FL 34203-9712 | 2019-10-09 |
| 1619419314 | Jashira Ruperto-swalls | Physician Assistant | 2020 59th St W, Bradenton, FL 34209-4604 | 2016-11-11 |
| 1871943209 | Laura Yvonne Vanhandel | Physician Assistant | 315 75th St W, Bradenton, FL 34209 | 2016-06-16 |
| Find all providers in BRADENTON | ||||
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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.