Provider Demographics
NPI:1851669766
Name:HELENIAK, JENNIFER (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:HELENIAK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3451 PINE RIDGE RD BLDG 601
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3922
Mailing Address - Country:US
Mailing Address - Phone:239-449-3072
Mailing Address - Fax:877-334-1886
Practice Address - Street 1:1660 MEDICAL BOUELVARD
Practice Address - Street 2:STE 200
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1416
Practice Address - Country:US
Practice Address - Phone:239-566-3434
Practice Address - Fax:239-566-2143
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9106306363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical