Healthcare Provider Details

I. General information

NPI: 1447281969
Provider Name (Legal Business Name): JENNIFER JOY AREGOOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 04/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 6TH AVE SOUTH ALL CHILDREN'S HOSPITAL
ST PETERSBURG FL
33701
US

IV. Provider business mailing address

9985 W BAY ST
SEMINOLE FL
33776-1536
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-7451
  • Fax:
Mailing address:
  • Phone: 303-957-8301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number49505
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: