Individual
JENNIFER L. BALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3280 N MCMULLEN BOOTH RD, SUITE 200, CLEARWATER, FL 33761-2029
(727) 216-1141
(727) 796-6459
Mailing address
PO BOX 102222, ATTN: CREDENTIAL DEPT, ATLANTA, GA 30368-2222
(239) 274-8200
(239) 278-3350
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
OS6862
FL
207RX0202X
Medical Oncology Physician
Primary
OS6861
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261639400
—
FL
Enumeration date
11/04/2005
Last updated
08/02/2022
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