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Individual

JEREMY WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(813) 971-6000
(813) 972-5753
Mailing address
12479 TELECOM DR, TEMPLE TERRACE, FL 33637-0913
(813) 972-4199
(813) 972-5753

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS11399
FL
207P00000X
Emergency Medicine Physician
OT011974
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003854800
FL
01
14F2G
BCBS FLORIDA
FL
Enumeration date
06/21/2007
Last updated
08/30/2011
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