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

Jordan Fuller, DO

Individual provider Internal Medicine Physician · NPI 1679922678

Jordan Fuller, DO is an Internal Medicine in Treasure Island, Florida. Graduated from Lake Erie College of Osteopathic Medicine, Erie in 2016, 10 years ago. Practices with Bayside Medical Group LLC, an 8-clinician group. Licensed in Florida.

Years since qualifying
10
Trained at
Lake Erie College of Osteopathic Medicine, Erie
Licensed in
FL
In the registry since
2016
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

61 Dolphin Dr
Treasure Island, FL 33706-3113
Phone: (727) 853-1701
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence OS15231 (FL)

Record details

NPI number1679922678
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 9, 2016
Last updated in NPPESApril 24, 2024
Certification dateApril 24, 2024

Medicare enrollment

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

Medicare specialtyINTERNAL MEDICINE
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, ERIE
Graduated 2016 (10 years in practice)
Group practice Bayside Medical Group Llc — 8 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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