EDWIN JACKSON

ST PETERSBURG, FL
NPI1740294883
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: FL  me 87406)
Additional Taxonomies2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry
(Licence: FL  me 87406)
Enumeration Date2006-07-27
Last Update Date2011-10-10
Business Address
-- EDWIN JACKSON M.D.
4010 CENTRAL AVE
ST PETERSBURG, FL 33711-1239
Phone number: 727-327-7656
Mailing Address
-- EDWIN JACKSON M.D.
4024 CENTRAL AVE
ST PETERSBURG, FL 33711-1239
Phone number: 727-327-7656