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

Jessica Blanco

Individual provider Physician Assistant · NPI 1083435549

Jessica Blanco is a Physician Assistant in Port Charlotte, Florida. Qualified in 2024, 2 years ago. Practices with Millennium Physician Group LLC, a 970-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
2
Licensed in
FL
In the registry since
2024

Practice location Address checks out

3340 Tamiami Trl
Port Charlotte, FL 33952-8088
Phone: (941) 764-5858
Fax: (941) 764-1657
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 115 W 15th St, Hialeah, FL 33010-3432 — (786) 343-1495

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9119370 (FL)

Record details

NPI number1083435549
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 17, 2024
Last updated in NPPESDecember 4, 2024
Certification dateDecember 4, 2024
Mailing address2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Millennium Physician Group Llc — 970 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations17 on file with Medicare

Other providers in Port Charlotte