Most Relevant Information
Provider Data
| NPI Number: | 1003826744 |
| Provider Name: | ELLEN VERENA JORGENSEN MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2080P0205X |
| Specialty: | Pediatrics |
| License Number: | ME54437 |
Most Important Dates
| Enumeration Date: | 08/08/2006 |
| Last Updated: | 01/04/2024 |
Provider Practice Location
12901 BRUCE B DOWNS BLVD
MDC 15
TAMPA
FL
336124742
Practice Location Phone/Fax
| Phone: | 8139742583 |
| Fax: |
Provider Mailing Location
PO BOX 917770
ORLANDO
FL
328910001
Provider Mailing Phone/Fax
| Phone: | 8139742201 |
| Fax: | 8139744325 |