MEDICARE: JENNIFER KITZEL 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
1	207L00000X	Anesthesiology Physician	ME 93845	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28647W	OTHER	FL	GTBA MEDICARE REASSIGN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	28647	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1326035007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER KITZEL MD

Provider Business Mailing Address
First Line	:	2 COLUMBIA DR
Second Line	:	SUITE A327
City	:	TAMPA
State	:	FL
Zip	:	33606-3508
Country	:	US
Telephone Number	:	813-844-4396
Fax Number	:	813-844-4972

Provider Business Practice Location Address
First Line	:	2 COLUMBIA DR
Second Line	:	SUITE A327
City	:	TAMPA
State	:	FL
Zip	:	33606-3508
Country	:	US
Telephone Number	:	813-844-4396
Fax Number	:	813-844-4972

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	03/05/2008

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Directions to “ JENNIFER KITZEL MD” Practice Location

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