Individual
ELLEN VERENA JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, MDC 15, TAMPA, FL 33612-4742
(813) 974-2583
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-4325
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
ME54437
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035500300
—
FL
01
—
07816
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/08/2006
Last updated
01/04/2024
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