| Mr Itamar Wall, APRN | |
|
1002 S Old Dixie Hwy Ste 204, Jupiter, FL 33458-7202 | |
| (561) 517-8678 | |
| (561) 529-5087 |
| Full Name | Mr Itamar Wall |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 1002 S Old Dixie Hwy Ste 204, Jupiter, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982243630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | APRN11005498 (Florida) | Primary |
| Entity Name | Personalized And Restorative Wellness Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710574413 PECOS PAC ID: 1951710086 Enrollment ID: O20210503000307 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Itamar Wall, APRN 2718 Danforth Ter, Wellington, FL 33414-3418 Ph: (561) 517-8678 | Mr Itamar Wall, APRN 1002 S Old Dixie Hwy Ste 204, Jupiter, FL 33458-7202 Ph: (561) 517-8678 |
Michele Shockley, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 136 Jupiter Lakes Blvd, Building 2000, Jupiter, FL 33458 Phone: 561-748-1888 | |
Tiffany Stureman, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5155 Corporate Way, Unit A, Jupiter, FL 33458 Phone: 561-624-0123 | |
Jessica Johnson, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3303 Duval St, Jupiter, FL 33458 Phone: 561-248-6875 | |
Mary Huser, ARNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 875 Military Trl, Suite 200, Jupiter, FL 33458 Phone: 561-746-2411 Fax: 561-354-0012 | |
Mrs. Mariya Yankelevych, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 210 Jupiter Lakes Blvd, Suite 4104, Jupiter, FL 33458 Phone: 561-743-9077 Fax: 561-743-9937 | |
Mrs. Dana Jean Glass, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4600 Military Trl Ste 107, Jupiter, FL 33458 Phone: 561-427-2000 Fax: 561-776-2565 | |
Camryn Sara Sartory, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4425 Military Trl Ste 203, Jupiter, FL 33458 Phone: 561-467-7138 |