Jenna Rose Bonaccorso, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS22105 Issued in FL

Practice address

5821 S Williamson Blvd Ste 201
Port Orange, FL 32128-6102

Phone

(386) 231-3420

Fax

(386) 231-3499

NPI assigned

Mar 26, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Florida Hospital Healthcare Partners, Inc

  • Internal Medicine Physician
  • Daytona Beach, FL
  • NPI 1780100529
  NPD
• Memorial Health Systems Inc

  • Surgery Physician
  • Daytona Beach, FL
  • NPI 1922115914
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1063973733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 W GRANADA BLVD STE 101",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5821 S WILLIAMSON BLVD STE 201",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286102",
            "telephone_number": "386-231-3420",
            "fax_number": "386-231-3499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Memorial Medical Pkwy Ste 405",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321175169",
            "country_code": "US",
            "telephone_number": "386-231-3420",
            "fax_number": "386-231-3499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONACCORSO",
        "first_name": "JENNA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS22105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Boehme
• Karen M Boggs, LCSW
• Lindsey Bolte, DC
• Tyler Bolvin, RBT
• Alicia Bommarito
• Julie Tessler Bonamo, OTR/L, CHT
• Amanda Rudd Bonnell
• Brenda Bookspan
• Samantha Boolman
• Hannah Elayna Bornamann, ATC

• Pediatrics Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.