Ellen Verena Jorgensen
Pediatrician Pediatric Endocrinologist
12901 Bruce B Downs Blvd Mdc 15
Tampa
, Florida 33612-4742
Ellen Verena Jorgensen
Pediatrician Pediatric Endocrinologist
12901 Bruce B Downs Blvd Mdc 15
Tampa
, Florida 33612-4742
(813) 974-4325
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About
Features
Specialties
- Pediatrician
- Pediatric Endocrinologist
Languages spoken
- English
Location
First Address
- Ellen Verena Jorgensen
- Po Box 917770
- Orlando, FL
- Zip : 32891-0001
- Fax : (813) 974-4325
- Phone : (813) 974-2201
Second Address
- Ellen Verena Jorgensen
- 12901 Bruce B Downs Blvd Mdc 15
- Tampa, FL
- Zip : 33612-4742
- Phone : (813) 974-2583
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | ME54437 | FL |
| Y | 2080P0205X | Pediatric Endocrinologist | ME54437 | FL |
National Provider Identifier
| NPI | 1003826744 |
|---|---|
| Provider Name | Ellen Verena Jorgensen |
| First Address | Orlando, FL 32891-0001 |
| Second Address | Tampa, FL 33612-4742 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/08/2006 |
| Last Update Date | 30/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 035500300 | (05) | FL |
| 07816 | BLUE CROSS BLUE SHIELD (01) | FL |
| E34017 | (02) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.