Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline Indrisek, PA

Individual provider Medical Physician Assistant · NPI 1427442011

Jacqueline Indrisek, PA is a Medical Physician Assistant in Port Charlotte, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2015
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

22655 Bayshore Rd Ste 130
Port Charlotte, FL 33980-2005
Phone: (941) 255-3722
Fax: (941) 255-3723
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8260 Gladiolus Dr, Fort Myers, FL 33908-4156 — (239) 437-5755

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9108209 (FL)

Record details

NPI number1427442011
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 23, 2015
Last updated in NPPESJune 7, 2023
Certification dateJune 7, 2023

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