Individual
DR. JENNIFER ANNE LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3001 WEST DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6307
(813) 870-4000
Mailing address
PO BOX 10030, DAYTONA BEACH, FL 32120-0030
(386) 274-7800
(386) 274-7801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME108114
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002733800
—
FL
01
—
14AOA
FLORIDA BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/12/2008
Last updated
02/25/2011
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