| Miss Tyesha Bowen, AGNP | |
| 
					1691 Forum Pl Ste B, West Palm Beach, FL 33401-2336  | |
| (561) 412-8992 | |
| (401) 238-6057 | 
| Full Name | Miss Tyesha Bowen | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Adult Health | 
| Location | 1691 Forum Pl Ste B, West Palm 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 | 
|---|---|---|---|
| 1629440516 | NPI | - | NPPES | 
| Entity Name | Lakeside Medical Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1356820286 PECOS PAC ID: 4789919028 Enrollment ID: O20190709003017  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Miss Tyesha Bowen, AGNP 276 Kensington Way, Royal Palm Beach, FL 33414-4316 Ph: (561) 412-8992  | Miss Tyesha Bowen, AGNP 1691 Forum Pl Ste B, West Palm Beach, FL 33401-2336 Ph: (561) 412-8992  | 
Ms. Jounette Noel, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 800 Clematis St, West Palm Beach, FL 33401 Phone: 561-891-1379  | |
Natalie Bales, MSN, APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1500 N Dixie Hwy Ste 104b, West Palm Beach, FL 33401 Phone: 561-790-8629 Fax: 561-721-8605  | |
Lazaro Antonio Machado Sanchez,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 850 Hill Dr Apt D, West Palm Beach, FL 33415 Phone: 786-399-9230  | |
Marissa Feo, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 971 Village Blvd, West Palm Beach, FL 33409 Phone: 561-688-5030 Fax: 561-688-9565  | |
Dr. Teresa A Kowalczyk-vitous, DNP.ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10155 Okeechobee Blvd, West Palm Beach, FL 33411 Phone: 561-204-2349  | |
Mr. George Nicholson Copeland, ARNP NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 319 Arlington Rd, West Palm Beach, FL 33405 Phone: 561-582-9683  | |
Carla Fazio, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1309 N Flagler Dr, West Palm Beach, FL 33401 Phone: 561-366-4100 Fax: 561-366-4189  |