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General NPI Number Information
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NPI Number | 1730683533
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Entity Type | Individual
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Provider Name | THOMAS KEITH JENKINS MD
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Gender | Male
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 6200 SW 73RD ST FL 2
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4679
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Country | US
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Telephone | 305-740-0823
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Fax |
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Provider Business Mailing Address
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Address Line | 407 NE 8TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32601-5593
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Country | US
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Telephone | 904-305-4398
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Fax | 904-305-4398
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME156014
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License Number State | FL
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