Provider Demographics
NPI:1760879159
Name:HARB, JENNIFER NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:NICOLE
Last Name:HARB
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 1:2441 OAK MYRTLE LN STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6334
Mailing Address - Country:US
Mailing Address - Phone:813-406-4835
Mailing Address - Fax:813-994-4835
Practice Address - Street 1:2441 OAK MYRTLE LN STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6334
Practice Address - Country:US
Practice Address - Phone:813-406-4835
Practice Address - Fax:813-994-4835
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138324207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology