Individual
JENNIFER LYNN PREWETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5 TAMPA GENERAL CIR, 8TH FLOOR, TAMPA, FL 33606-3601
(813) 844-3228
(813) 844-7730
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770
(813) 974-0706
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA3507
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290411000
—
FL
01
—
P00128461
RAILROAD MEDICARE
—
Enumeration date
04/12/2006
Last updated
01/26/2017
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