Provider Demographics
NPI:1215103775
Name:SWEENEY, JENNIFER (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12902 USF MAGNOLIA DR
Mailing Address - Street 2:MMG -MOD A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-9416
Mailing Address - Country:US
Mailing Address - Phone:813-745-3587
Mailing Address - Fax:813-745-4226
Practice Address - Street 1:14055 RIVEREDGE DR STE 250
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-2141
Practice Address - Country:US
Practice Address - Phone:813-929-5451
Practice Address - Fax:813-929-5465
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2025-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME933192085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology