Individual
JACLYN S BELLASSAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
8416 TIDAL BREEZE DR, RIVERVIEW, FL 33569
(813) 403-4423
(813) 433-3124
Mailing address
8416 TIDAL BREEZE DR, RIVERVIEW, FL 33569-4722
(813) 403-4423
(813) 433-3124
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN9311008
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN9311008
FL
363LP2300X
Primary Care Nurse Practitioner
ARNP93110008
FL
Other
Enumeration date
09/13/2018
Last updated
11/07/2023
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