Provider Demographics
NPI:1295702603
Name:BIELLO, ANTHONY PATRICK (PA-C)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:PATRICK
Last Name:BIELLO
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:6800 SOUTHPOINT PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8203
Mailing Address - Country:US
Mailing Address - Phone:904-634-0604
Mailing Address - Fax:904-634-0203
Practice Address - Street 1:2300 PARK AVE STE 206
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5573
Practice Address - Country:US
Practice Address - Phone:904-634-0640
Practice Address - Fax:904-634-0220
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2024-02-20
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Provider Licenses
StateLicense IDTaxonomies
FLPA9111112363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant