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

Loren E Bonenclark, PA-C

Individual provider Surgical Physician Assistant · NPI 1639629579

Loren E Bonenclark, PA-C is a Physician Assistant in Jacksonville, Florida. Qualified in 2016, 10 years ago. Accepts Medicare assignment. Licensed in Florida and Maryland.

Years since qualifying
10
Licensed in
FL, MD
In the registry since
2016
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1301 Palm Ave
Jacksonville, FL 32207-8432
Phone: (904) 202-7300
Fax: (904) 202-7433
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9112402 (FL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA9112402 (FL)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence C06217 (MD)

Record details

NPI number1639629579
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 4, 2016
Last updated in NPPESSeptember 24, 2019
Mailing addressPo Box 45278, Jacksonville, FL 32232-5278

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Jacksonville