Individual provider · Type 1 NPI

Jacqueline Indrisek, PA

Medical Physician Assistant · Port Charlotte, FL

NPI number 1427442011 Active

Practice location

22655 Bayshore Rd Ste 130
Port Charlotte, FL 33980-2005

Call (941) 255-3722 Map

Fax (941) 255-3723

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147

Other practice locations

  • 8260 Gladiolus Dr, Fort Myers, FL 33908-4156 · (239) 437-5755

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9108209 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1427442011

Jacqueline Indrisek, PA's National Provider Identifier is 1427442011, issued on Mar 23, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Port Charlotte, FL. The record was last updated on Jun 7, 2023.