Provider Demographics
NPI:1326337577
Name:FERGESON, JENNIFER ENDAYA (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ENDAYA
Last Name:FERGESON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 S TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6405
Mailing Address - Country:US
Mailing Address - Phone:941-927-4888
Mailing Address - Fax:941-927-5808
Practice Address - Street 1:3570 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6405
Practice Address - Country:US
Practice Address - Phone:941-927-4888
Practice Address - Fax:941-927-5808
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12455207R00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine