Individual
JACQUELINE AMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 TAMPA GENERAL CIR, STC 6TH FLOOR, TAMPA, FL 33606-3603
(813) 259-8500
(813) 259-8623
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME128045
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017899900
—
FL
01
—
BZCWI
BLUE CROSS BLUE SHIELD FLORIDA
FL
Enumeration date
04/10/2012
Last updated
10/22/2020
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