Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marisa Rene Fullgrapp, PA-C

Individual provider Physician Assistant · NPI 1992399026

Marisa Rene Fullgrapp, PA-C is a Physician Assistant in Bradenton, Florida. Qualified in 2021, 5 years ago. Practices with Florida Medical Specialists LLC, a 124-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6110 State Road 70 E
Bradenton, FL 34203-9712
Phone: (941) 755-4242
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9114046 (FL)

Record details

NPI number1992399026
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMarch 1, 2021
Last updated in NPPESMarch 1, 2021
Certification dateMarch 1, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Florida Medical Specialists Llc — 124 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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