Provider Demographics
NPI:1770963357
Name:UTOH, JENNIFER GWENDOLYN (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GWENDOLYN
Last Name:UTOH
Suffix:
Gender:
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3168
Mailing Address - Country:US
Mailing Address - Phone:713-673-9000
Mailing Address - Fax:855-895-8495
Practice Address - Street 1:1910 JOHN RALSTON RD STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77013-5531
Practice Address - Country:US
Practice Address - Phone:713-673-9000
Practice Address - Fax:855-895-8185
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2025-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXR3768207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine