Individual
MR. JEFFREY DANIEL BIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10050 SW INNOVATION WAY STE 102, PORT ST LUCIE, FL 34987-2117
(772) 344-3811
(772) 344-3890
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-2832
(772) 223-5653
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9106397
FL
363AM0700X
Medical Physician Assistant
PA9106397
FL
363AS0400X
Surgical Physician Assistant
PA9106397
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6732100002
MEDICARE DME
FL
01
—
Y09WA
FLORIDA BLUE
FL
Enumeration date
01/27/2012
Last updated
10/14/2020
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