Individual
JENNIFER M WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3515 E FLETCHER AVE, MDC90, TAMPA, FL 33613-4702
(813) 974-8900
(813) 974-2478
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-8900
(813) 974-2478
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME 110281
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003961500
—
FL
01
—
14F6R
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/28/2007
Last updated
12/16/2011
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