| Andrea Distefano, FNP-BC | |
|
103 Solana Rd, Suite B, Ponte Vedra Beach, FL 32082-2231 | |
| (904) 273-2717 | |
| (904) 273-0410 |
| Full Name | Andrea Distefano |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 103 Solana Rd, Ponte Vedra Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639580236 | NPI | - | NPPES |
| 9262502 | Other | FL ARNP LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 9262502 (Florida) | Primary |
| Entity Name | Beaches Dermatology, P.a. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780627521 PECOS PAC ID: 9133190549 Enrollment ID: O20040802000141 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrea Distefano, FNP-BC 103 Solana Rd, Suite B, Ponte Vedra Beach, FL 32082-2231 Ph: (904) 273-2717 | Andrea Distefano, FNP-BC 103 Solana Rd, Suite B, Ponte Vedra Beach, FL 32082-2231 Ph: (904) 273-2717 |
Dr. Hillary Marie Luke-tindley, DNP, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10870 Us One N Unit 104, Ponte Vedra Beach, FL 32081 Phone: 904-438-2720 | |
Mrs. Gabriela Elena Fratila, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 228 Ponte Vedra Park Dr Ste 500, Ponte Vedra Beach, FL 32082 Phone: 904-273-1180 Fax: 904-273-6116 | |
Katrina Torres, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 42 Davin Ct, Ponte Vedra Beach, FL 32082 Phone: 904-490-0264 | |
Desirae Lemmon, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1102 A1a N Ste 104, Ponte Vedra Beach, FL 32082 Phone: 904-273-6533 Fax: 904-273-6532 | |
Mrs. Claudette Narcisa Walker, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 209 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082 Phone: 904-273-6200 Fax: 904-273-6100 | |
Laura Lui, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 152 Front St, Ponte Vedra Beach, FL 32082 Phone: 904-285-3634 | |
Tracie Nusca Parrish, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 152 Front St, Ponte Vedra Beach, FL 32082 Phone: 904-285-3634 |