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Individual
DR. PETER R. JENSEN
Active
Individual
DR. PETER R. JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
049593
CT
207RN0300X
Nephrology Physician
ME79683
FL
208M00000X
Hospitalist Physician
Primary
049593
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15629
BCBS
FL
05
—
264418500
—
FL
01
—
390008415
MEDICARE RR
FL
01
—
800031974
TAX ID
FL
Enumeration date
08/16/2005
Last updated
01/06/2015
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