Individual
JESSICA BOEGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO, MED
Contact information
Practice address
92 W MILLER ST, ORLANDO, FL 32806-2032
(321) 841-5104
(321) 841-6871
Mailing address
92 W MILLER ST, ORLANDO, FL 32806-2032
(321) 841-5104
(321) 841-6871
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
OS19046
FL
390200000X
Student in an Organized Health Care Education/Training Program
OS19046
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/29/2019
Last updated
08/28/2025
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