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NPI Code Detail

MEDICARE: MRS. JENNIFER BRZOSOWICZ M.S., CGC

MEDICARE: MRS. JENNIFER BRZOSOWICZ M.S., CGC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1170300000XGenetic Counselor (M.S.)

General Provider Information

NPI Number : 1467858217
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER BRZOSOWICZ M.S., CGC
Provider Business Mailing Address
First Line : 4117 E FOWLER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33617-2011
Country : US
Telephone Number : 813-745-4746
Fax Number :
Provider Business Practice Location Address
First Line : 4117 E FOWLER AVE
Second Line :
City : TAMPA
State : FL
Zip : 33617-2011
Country : US
Telephone Number : 813-745-4746
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2014
Last Update Date : 11/06/2014

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