Individual
JACQUELINE BLUTCHER GOLLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
205 MARTIN LUTHER KING, JR. ST. NO., PINELLAS COUNTY HEALTH DEPARTMENT, ST. PETERSBURG, FL 33701-3109
(727) 824-6900
Mailing address
P.O. BOX 290919, TEMPLE TERRACE, FL 33687-0919
(813) 988-7844
(813) 984-7161
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME 0037797
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06973100
—
FL
Enumeration date
12/26/2013
Last updated
12/26/2013
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