| Jessica Blanco, | |
|
3340 Tamiami Trl, Port Charlotte, FL 33952-8088 | |
| (941) 764-5858 | |
| (941) 764-1657 |
| Full Name | Jessica Blanco |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 2 Years |
| Location | 3340 Tamiami Trl, Port Charlotte, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083435549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 9119370 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hca Florida Fawcett Hospital | Port charlotte, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Millennium Physician Group Llc | 9830244433 | 976 |
| Entity Name | Millennium Physician Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811122880 PECOS PAC ID: 9830244433 Enrollment ID: O20090903000338 |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica Blanco, 2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342 Ph: (877) 856-3774 | Jessica Blanco, 3340 Tamiami Trl, Port Charlotte, FL 33952-8088 Ph: (941) 764-5858 |
Tyler Thomas Reed, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2400 Harbor Blvd Ste 7, Port Charlotte, FL 33952 Phone: 941-766-5095 Fax: 941-206-0326 |
Grace Colarossi, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1641 Tamiami Trl Ste 1, Port Charlotte, FL 33948 Phone: 941-629-6262 |
David Andrew Kellenberger, PA, RD Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2343 Aaron St, Port Charlotte, FL 33952 Phone: 855-979-5700 Fax: 855-979-5701 |
Mrs. Susan Jane Nolan, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 22655 Bayshore Rd Ste 110, Port Charlotte, FL 33980 Phone: 941-235-4900 Fax: 941-235-4901 |
Grace Diana Tice, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 1641 Tamiami Trl Ste 1, Port Charlotte, FL 33948 Phone: 941-629-6262 |
Iris Jeanne Swiderski, DHSC, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 21298 Olean Blvd, Port Charlotte, FL 33952 Phone: 941-629-1181 |
Karlie Sweiderk, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2040 Tamiami Trl, Port Charlotte, FL 33948 Phone: 856-558-2924 |