Individual
JENNIFER TAKAGISHI
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) 259-8755
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME80987
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259491900
—
FL
01
—
35858
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/10/2006
Last updated
10/30/2020
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