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1710040480
LEWIS JACKSON
MIAMI, FL
NPI
1710040480
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207QG0300X Family Medicine, Geriatric Medicine
(Licence: FL ME94517)
Enumeration Date
2006-12-18
Last Update Date
2007-07-08
Business Address
Dr. LEWIS JACKSON M.D.
1611 NW 12TH AVE
MIAMI, FL 33136-1005
Phone number: 305-575-3388
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Mailing Address
Dr. LEWIS JACKSON M.D.
7125 BAY DR APT202
MIAMI BEACH, FL 33141-5476
Phone number: 305-867-2676
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