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General NPI Number Information
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NPI Number | 1740741966
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Entity Type | Individual
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Provider Name | JARED MICHAEL SENVISKY MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 07/19/2024
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-3438
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Country | US
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Telephone | 216-445-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 17 DAVIS BLVD STE 308
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City | TAMPA
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State | FL
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Zip | 33606-3438
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Country | US
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Telephone |
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME152557
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 35.150711
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License Number State | OH
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