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NPI Code Detail

MEDICARE: JESSICA LYNNE JENNINGS MD

MEDICARE: JESSICA LYNNE JENNINGS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianME122346FL

General Provider Information

NPI Number : 1023245982
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LYNNE JENNINGS MD
Provider Business Mailing Address
First Line : PO BOX 82969
Second Line :
City : TAMPA
State : FL
Zip : 33682-2969
Country : US
Telephone Number : 813-866-0930
Fax Number : 813-866-0929
Provider Business Practice Location Address
First Line : 302 W FLETCHER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-3415
Country : US
Telephone Number : 813-397-5305
Fax Number : 813-549-7855
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2009
Last Update Date : 05/14/2015

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