Provider Demographics
NPI:1528227691
Name:LOH, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LOH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARIA
Other - Last Name:MERCADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8585 SUNSET DR STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3746
Mailing Address - Country:US
Mailing Address - Phone:786-558-8542
Mailing Address - Fax:786-431-5993
Practice Address - Street 1:8585 SUNSET DR STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-3746
Practice Address - Country:US
Practice Address - Phone:786-558-8542
Practice Address - Fax:786-431-5993
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110442207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004529900Medicaid
FL14J63OtherBCBS
FL369851OtherAVMED
FL14J63OtherBCBS