Healthcare Provider Details

I. General information

NPI: 1326402207
Provider Name (Legal Business Name): JESSICA HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 E FLETCHER AVE
TAMPA FL
33613-4613
US

IV. Provider business mailing address

10400 LITTLE PATUXENT PKWY STE 240
COLUMBIA MD
21044-3540
US

V. Phone/Fax

Practice location:
  • Phone: 813-971-6000
  • Fax:
Mailing address:
  • Phone: 443-276-7624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME158427
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: