Healthcare Provider Details

I. General information

NPI: 1326131202
Provider Name (Legal Business Name): JENNIFER AUERBACH HIPP D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER AUERBACH HIPP D.O.

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 KING ST
JACKSONVILLE FL
32204-2410
US

IV. Provider business mailing address

900 UNIVERSITY BLVD N MC-75
JACKSONVILLE FL
32211-9230
US

V. Phone/Fax

Practice location:
  • Phone: 904-760-4904
  • Fax: 904-760-4651
Mailing address:
  • Phone: 904-253-2062
  • Fax: 904-253-1942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS9866
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: