DR. JACKELINE D BRICENO (NPI# 1619043684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619043684 |
| Entity Type | Individual |
| Full Name | DR. JACKELINE D BRICENO |
| Credential | M.D. |
| Practice Address |
2221 Se Ocean Blvd Suite 100 Stuart FL 34996-3341 |
| Practice Telephone | 7722834428 |
| Practice Fax Number | 7722880192 |
| Mailing Telephone | 7722834428 |
| Mailing Fax Number | 7722880192 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2019-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | ME75870 | FL | Other Service Providers |
| Y | 207R00000X | Internal Medicine | ME75870 | FL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 40100 Highway 27, Davenport, FL 338375906 | 8634224971 | 8634192264 |
| Street Address |
2221 SE OCEAN BLVD SUITE 100 |
| City | STUART |
| State | FL |
| Zip Code | 34996-3341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194711713 | Richard Oswald Follwell | Surgery | 2221 Se Ocean Blvd, Suite 200, Stuart, FL 34996-3341 | 2005-09-20 |
| 1063998243 | Kayleigh C Hudson | Physician Assistant | 2221 Se Ocean Blvd, Stuart, FL 34996-3341 | 2018-07-11 |
| 1639603830 | Francesca Panko | Nurse Practitioner | 2221 Se Ocean Blvd, Suite 100, Stuart, FL 34996-3341 | 2017-04-13 |
| 1144776790 | Leah Elizabeth Acker | Nurse Practitioner | 2221 Se Ocean Blvd, Stuart, FL 34996 | 2016-09-01 |
| 1932567872 | Nichele Cuevas | Nurse Practitioner | 2221 Se Ocean Blvd, Stuart, FL 34996-3341 | 2016-02-07 |
| 1265667232 | Pamela Leigh Rey Norris | Speech-Language Pathologist | 2221 Se Ocean Blvd, Suite 300, Stuart, FL 34996-3341 | 2009-05-20 |
| 1982878393 | Adrienne G Sacco | Audiologist | 2221 Se Ocean Blvd, Suite 300, Stuart, FL 34996-3341 | 2008-04-16 |
| 1780858100 | Ellen D Kabath | Audiologist | 2221 Se Ocean Blvd, Suite 300, Stuart, FL 34996-3341 | 2008-04-16 |
| 1215129549 | John Bacha | Surgery | 2221 Se Ocean Blvd, Ste 200, Stuart, FL 34996-3341 | 2007-08-10 |
| 1770675530 | Robert M Dermarkarian | Internal Medicine | 2221 Se Ocean Blvd, Suite 100, Stuart, FL 34996-3341 | 2006-09-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164061578 | See and Sun Optical | Technician/Technologist | 3736 Se Ocean Blvd, Stuart, FL 34996 | 2020-01-02 |
| 1528558822 | Shweta Frechette | Nurse Practitioner | 2221 Se Ocean Blvd Ste 100, Stuart, FL 34996 | 2018-05-14 |
| 1790273944 | Harbour Bay Pharmacy LLC | Pharmacy | 3754 Se Ocean Blvd Ste B, Stuart, FL 34996 | 2018-04-24 |
| 1053828921 | Barbara Ann Ohara | Counselor | 2929 S.e. Ocean Blvd., Stuart, FL 34996 | 2018-01-02 |
| 1417370651 | National Laboratories, LLC | Clinical Medical Laboratory | 1411 Se Ocean Avenue, Stuart, FL 34996 | 2014-01-23 |
| 1972871747 | Cara Montgomery | Counselor | 850 Se Stafford Dr, Stuart, FL 34996 | 2011-12-08 |
| 1053557603 | Glenn Allen Feigen | Licensed Practical Nurse | 3727 Se Ocean Blvd # 200b, General Healthcare Resources, Inc., Stuart, FL 34996 | 2009-01-05 |
| 1861665044 | Robert O. Baratta | Internal Medicine | 2400 Se Monterey Road, Suite 300, Stuart, FL 34996 | 2008-04-08 |
| 1336343102 | Avron H Lipschitz | Plastic Surgery | 903 Se Monterey Commons Blvd, Stuart, FL 34996 | 2007-06-13 |
| 1912129214 | Eyewear of Stuart, Inc. | Durable Medical Equipment & Medical Supplies | 2090 S.e. Ocean Blvd, Stuart, FL 34996 | 2007-05-03 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114461977 | Mehan Medical Consulting LLC | Internal Medicine | 509 Se Riverside Dr Ste 300, Stuart, FL 34994-2579 | 2016-12-14 |
| 1578012035 | Essentials Medical Group, LLC | Internal Medicine | 2694 Se Willoughby Blvd, Stuart, FL 34994 | 2016-09-26 |
| 1750756276 | Doctors House Calls of Florida, LLC | Internal Medicine | 1239 Se Indian St Ste 102, Stuart, FL 34997-5633 | 2015-12-09 |
| 1144631979 | Lindsey Patterson | Internal Medicine | 2150 Se Salerno Rd Ste 200, Stuart, FL 34997-6572 | 2014-05-14 |
| 1942437090 | Valerie Anne Barrett | Internal Medicine | 2410 N Federal Hwy, Stuart, FL 34994 | 2009-06-16 |
| 1861665044 | Robert O. Baratta | Internal Medicine | 2400 Se Monterey Road, Suite 300, Stuart, FL 34996 | 2008-04-08 |
| 1649456443 | Physician On Call LLC | Internal Medicine | 850 Nw Federal Hwy, Suite 151, Stuart, FL 34994-1000 | 2008-01-11 |
| 1598951949 | Carl C Gittens Md Pa | Internal Medicine | 789 Sw Federal Hwy Ste 212, Stuart, FL 34994-2962 | 2007-09-19 |
| 1881894871 | Gloria Garcia | Internal Medicine | 2021 Se Riverside Dr, Stuart, FL 34996-1209 | 2007-07-19 |
| 1679780563 | Benjamin John Ngo | Internal Medicine | 509 Se Riverside Dr Ste 301, Stuart, FL 34994 | 2007-05-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.