JACQUELINE BLUTCHER GOLLMAN


Address: 205 Martin Luther King, Jr. St. No., Pinellas County Health Department, St. Petersburg, FL 33701-3109
Phone: 7278246900

JACQUELINE BLUTCHER GOLLMAN (NPI# 1215358981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215358981
Entity Type Individual
Full Name JACQUELINE BLUTCHER GOLLMAN
Other Name DR. JACQUELINE GOLLMAN BLUTCHER
Credential MD
Practice Address 205 Martin Luther King, Jr. St. No.
Pinellas County Health Department
St. Petersburg
FL 33701-3109
Mailing Address P.o. Box 290919
Temple Terrace
FL 33687-0919
Practice Telephone 7278246900
Mailing Telephone 8139887844
Mailing Fax Number 8139847161
Enumeration Date 2013-12-26
Last Update Date 2013-12-26
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice ME 0037797 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 06973100 05

Office Location

Street Address 205 MARTIN LUTHER KING, JR. ST. NO.
PINELLAS COUNTY HEALTH DEPARTMENT
City ST. PETERSBURG
State FL
Zip Code 33701-3109

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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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Competitor

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City ST. PETERSBURG
Zip Code 33701

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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