Individual
MRS. JENNA ROSE BONACCORSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5821 S WILLIAMSON BLVD STE 201, PORT ORANGE, FL 32128-6102
(386) 231-3420
(386) 231-3499
Mailing address
770 W GRANADA BLVD STE 101, ORMOND BEACH, FL 32174-5179
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS22105
FL
Other
Enumeration date
03/26/2019
Last updated
08/26/2025
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