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NPI Code Detail

MEDICARE: JELIENA N KRILL PA-C

MEDICARE: JELIENA N KRILL PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA9109787FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11408849OTHERFLWELLCARE MEDICARE/MEDICAID
6P01748831OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2OLW1WOTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
40375748OTHERFLCIGNA
5398579OTHERFLAVMED
74928066OTHERFLAETNA
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689122053
Entity Type Code : Individual
Provider Name (Legal Business Name) : JELIENA N KRILL PA-C
Provider Business Mailing Address
First Line : 9617 GULF RESEARCH LN
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4560
Country : US
Telephone Number : 239-418-0999
Fax Number : 239-418-0091
Provider Business Practice Location Address
First Line : 9617 GULF RESEARCH LN
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4560
Country : US
Telephone Number : 239-418-0999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2016
Last Update Date : 02/05/2025

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Directions to “ JELIENA N KRILL PA-C” Practice Location

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