DEREK C JACKSON

ORLANDO, FL
NPI1811979123
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: FL  PA9101356)
Enumeration Date2005-11-14
Last Update Date2007-07-08
Business Address
-- DEREK C JACKSON PA
601 E ROLLINS ST
ORLANDO, FL 32803-1248
Phone number: 407-303-5600
Mailing Address
-- DEREK C JACKSON PA
500 WINDERLEY PL SUITE 115
MAITLAND, FL 32751-7247
Phone number: 407-875-8784