Provider Demographics
NPI:1073724068
Name:CO-VU, JENNIFER GO (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:GO
Last Name:CO-VU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:GO
Other - Last Name:CO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:BADER 202
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-7770
Mailing Address - Fax:352-392-0547
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:BADER 202
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-273-7770
Practice Address - Fax:352-392-0547
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50631-202080P0202X
FLME1100232080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFC140ZMedicare PIN