Healthcare Provider Details

I. General information

NPI: 1518302942
Provider Name (Legal Business Name): JENNIFER LEIGH RAMMEL MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

841 PRUDENTIAL DR
JACKSONVILLE FL
32207-8329
US

IV. Provider business mailing address

PO BOX 44008
JACKSONVILLE FL
32231-4008
US

V. Phone/Fax

Practice location:
  • Phone: 904-633-0920
  • Fax: 904-633-0921
Mailing address:
  • Phone: 904-244-3660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME139828
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License NumberME139828
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: