Individual
JAIME PENIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3001 WEST MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607
(813) 870-4933
(813) 870-4887
Mailing address
3001 W MLK JR BLVD, TAMPA, FL 33607
(813) 870-4933
(813) 870-4887
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME0096543
FL
207RN0300X
Nephrology Physician
Primary
ME96543
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277156000
—
FL
01
—
56664
BCBS
FL
Enumeration date
08/20/2006
Last updated
06/25/2010
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