Provider Demographics
NPI:1427227057
Name:BILECKI, JEROME JUDE (APRN-BC)
Entity Type:Individual
Prefix:MR
First Name:JEROME
Middle Name:JUDE
Last Name:BILECKI
Suffix:
Gender:M
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 291282
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33329-1282
Mailing Address - Country:US
Mailing Address - Phone:954-292-6897
Mailing Address - Fax:
Practice Address - Street 1:8666 BLAZE CT
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-8661
Practice Address - Country:US
Practice Address - Phone:954-292-6897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9184475363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health