Provider Demographics
NPI:1407837321
Name:STEEL, JENNIFER RODY (MD)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:RODY
Last Name:STEEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3152 LITTLE RD
Mailing Address - Street 2:# 162
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1864
Mailing Address - Country:US
Mailing Address - Phone:727-376-6578
Mailing Address - Fax:727-376-6784
Practice Address - Street 1:6600 MADISON ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1971
Practice Address - Country:US
Practice Address - Phone:727-376-6578
Practice Address - Fax:727-376-6784
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 64072208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
237735OtherAUMED
19622OtherWELLCARE
23117OtherBLUE CROSS BLUE SHIELD
237735OtherAUMED
23117OtherBLUE CROSS BLUE SHIELD