Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | OS6862 | FL |
N | 207RH0003X | Hematology & Oncology | 0S6862 | FL |
Y | 207RX0202X | Medical Oncology | OS6861 | FL |
NPI | 1386635548 |
---|---|
Provider Name | Jennifer L. Ball |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Clearwater, FL 33761-2029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2005 |
Last Update Date | 02/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
261639400 | (05) | FL |
49870 | BLUE CROSS / BLUE SHIELD (01) | FL |
H23482 | (02) | |
P00090341 | MEDICARE RR (01) | FL |