Doctor profile · Federal record
Dr. Jenna Bonaccorso, DO
Pediatrics Physician · Port Orange, FL
- NPI 1063973733
- 7 yrs on file
- Female
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
5821 S Williamson Blvd Ste 201
Port Orange, FL 321286102
(386) 231-3420
fax (386) 231-3499 - Additional location
-
305 Memorial Medical Pkwy Ste 405
Daytona Beach, FL 321175169 - Mailing address
-
770 W Granada Blvd Ste 101
Ormond Beach, FL 321745179
Credentials & registration
- NPI registered
- March 2019 — 7 yrs on file
- Profile last updated
- August 26, 2025
- Specialty taxonomy
- 208000000X — NUCC code
- State license (1)
- Florida #OS22105
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1063973733. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$21
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| GlaxoSmithKline, LLC. | 1 | $20.52 |
By nature of payment
Frequently asked questions
What is Dr. Jenna Bonaccorso's medical specialty?
Dr. Jenna Bonaccorso practices Pediatrics Physician in Port Orange, FL.
Where does Dr. Jenna Bonaccorso practice?
Dr. Jenna Bonaccorso practices at 5821 S Williamson Blvd Ste 201, Port Orange, FL 321286102. Office phone: 3862313420.
What is Dr. Jenna Bonaccorso's NPI?
Dr. Jenna Bonaccorso's National Provider Identifier (NPI) is 1063973733, issued by NPPES.