Provider Demographics
NPI:1265661680
Name:HELMRICK-BLOSSOM, JESSIN (MD)
Entity type:Individual
Prefix:DR
First Name:JESSIN
Middle Name:
Last Name:HELMRICK-BLOSSOM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JESSIN
Other - Middle Name:
Other - Last Name:BLOSSOM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3320 SW 34TH CIR
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-3371
Mailing Address - Country:US
Mailing Address - Phone:352-629-8154
Mailing Address - Fax:352-629-5231
Practice Address - Street 1:3320 SW 34TH CIR
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-3371
Practice Address - Country:US
Practice Address - Phone:352-629-8154
Practice Address - Fax:352-629-5231
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME143048207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology