Organization
THE CHILDRENS DOCTOR OF TAMPABAY, JACQUELIN ENIEBLES MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE MARIA NIEBLES M.D (DIRECTOR)
(727) 481-8075
Entity
Organization
Contact information
Practice address
14499 NORTH DALE MABRY HWY, SUITE 180-S, TAMPA, FL 34683
(727) 481-8075
Mailing address
1375 INDIAN TRAILS NORTH, PALM HARBOR, FL 34683
(727) 481-8075
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME66997
FL
Other
Enumeration date
04/12/2017
Last updated
04/19/2017
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