Provider Demographics
NPI:1912132218
Name:CIOFFI, JESSICA L (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:L
Last Name:CIOFFI
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 1:1600 SW ARCHER RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-3003
Mailing Address - Country:US
Mailing Address - Phone:352-265-0889
Mailing Address - Fax:352-265-0622
Practice Address - Street 1:1968 PEACHTREE RD NW BLDG 775TH
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-605-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-16
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME124836208600000X
IN01074001A208600000X
GA85000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015277400Medicaid
IN201225320Medicaid
INP01350388Medicare PIN
IN233690034Medicare PIN
FL015277400Medicaid