Individual
DR. JENNIFER LICHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1900 S TUTTLE AVE, SARASOTA, FL 34239-3114
(941) 330-8885
Mailing address
1900 S TUTTLE AVE, SARASOTA, FL 34239-3114
(248) 672-0162
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
5101022079
MI
207V00000X
Obstetrics & Gynecology Physician
Primary
OS16126
FL
Other
Enumeration date
06/30/2015
Last updated
07/16/2019
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