Individual
JESSICA DIFO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 TAMPA GENERAL CIR, TGH INTERVENTIONAL RADIOLOGY, TAMPA, FL 33606-3571
(813) 844-4570
(813) 844-4032
Mailing address
2700 UNIVERSITY SQUARE DR, RADIOLOGY ASSOC OF TAMPA, TAMPA, FL 33612-5513
(813) 251-5822
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 9103704
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292737300
—
FL
01
—
Y00S4
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/26/2007
Last updated
11/02/2011
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