| Mr Jonathan Cleon Hendricks, PA-C | |
|
636 Del Prado Boulevard, Cape Coral, FL 33990-2695 | |
| (239) 424-2222 | |
| Not Available |
| Full Name | Mr Jonathan Cleon Hendricks |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 636 Del Prado Boulevard, Cape Coral, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033185699 | NPI | - | NPPES |
| 291231700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9101920 (Florida) | Primary |
| Entity Name | Peacehealth |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356309553 PECOS PAC ID: 9537073960 Enrollment ID: O20031118001062 |
| Entity Name | Northwest Physician Associates PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275567919 PECOS PAC ID: 4183523806 Enrollment ID: O20031231000754 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jonathan Cleon Hendricks, PA-C 4131 Matia Dr, Ferndale, WA 98248-9539 Ph: (523) 561-2513 | Mr Jonathan Cleon Hendricks, PA-C 636 Del Prado Boulevard, Cape Coral, FL 33990-2695 Ph: (239) 424-2222 |
Navya Miryala, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 2125 Se 16th Pl, Cape Coral, FL 33990 Phone: 239-458-1131 |
Kristen Jeanine Nearing, PA Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 636 Del Prado Blvd S, Cape Coral, FL 33990 Phone: 239-424-3513 |
Summer Stagman, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 708 Del Prado Blvd S Ste 6, Cape Coral, FL 33990 Phone: 239-424-2755 |
Miss Kimberly Ann Burgess, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2656 Blue Cypress Lake Ct, Cape Coral, FL 33909 Phone: 954-448-5636 |
Tara Michelle Stepp, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1682 Ne Pine Island Rd, Cape Coral, FL 33909 Phone: 239-424-1655 Fax: 239-424-1649 |
Mr. Alexander Gregory Waelchli, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 636 Del Prado Blvd S, Cape Coral, FL 33990 Phone: 239-424-2000 |
Nisha Patel Gupta, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 636 Del Prado Blvd S, Cape Coral, FL 33990 Phone: 239-424-2000 |