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General NPI Number Information
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NPI Number | 1386635548
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Entity Type | Individual
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Provider Name | JENNIFER L. BALL DO
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Gender | Female
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 3280 N MCMULLEN BOOTH RD SUITE 200
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City | CLEARWATER
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State | FL
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Zip | 33761-2029
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Country | US
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Telephone | 727-216-1141
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Fax | 727-796-6459
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Provider Business Mailing Address
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Address Line | PO BOX 102222 ATTN: CREDENTIAL DEPT
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City | ATLANTA
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State | GA
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Zip | 30368-2222
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Country | US
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Telephone | 239-274-8200
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Fax | 239-278-3350
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | OS6862
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | OS6861
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License Number State | FL
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