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NPI Code Detail

MEDICARE: JENNIFER MARIKO THOMPSON MD

MEDICARE: JENNIFER MARIKO THOMPSON MD
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
12080A0000XPediatric Adolescent Medicine PhysicianME150409FL

General Provider Information

NPI Number : 1629565999
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MARIKO THOMPSON MD
Provider Business Mailing Address
First Line : 4321 N MACDILL AVE STE 407
Second Line :
City : TAMPA
State : FL
Zip : 33607-6396
Country : US
Telephone Number : 813-217-9384
Fax Number : 813-443-8167
Provider Business Practice Location Address
First Line : 4321 N MACDILL AVE STE 407
Second Line :
City : TAMPA
State : FL
Zip : 33607-6396
Country : US
Telephone Number : 813-217-9384
Fax Number : 813-443-8167
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2018
Last Update Date : 05/18/2026

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