Provider Demographics
NPI:1447281969
Name:AREGOOD, JENNIFER JOY (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOY
Last Name:AREGOOD
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 1:9985 W BAY ST
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33776-1536
Mailing Address - Country:US
Mailing Address - Phone:303-957-8301
Mailing Address - Fax:
Practice Address - Street 1:501 6TH AVE SOUTH
Practice Address - Street 2:ALL CHILDREN'S HOSPITAL
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701
Practice Address - Country:US
Practice Address - Phone:727-898-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO49505208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics