Provider Demographics
NPI:1851323232
Name:DOLAN, JENNY E (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNY
Middle Name:E
Last Name:DOLAN
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 1:601 5TH ST S
Mailing Address - Street 2:5TH FLOOR DEPT 6941
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701
Mailing Address - Country:US
Mailing Address - Phone:727-767-3051
Mailing Address - Fax:727-767-8420
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:5TH FLOOR DEPT 6941
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701
Practice Address - Country:US
Practice Address - Phone:727-767-3051
Practice Address - Fax:727-767-8420
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92585207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16446Medicare ID - Type Unspecified
FLI38823Medicare UPIN