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1952444721
JUDITH JACKSON
TAMPA, FL
NPI
1952444721
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: FL ARNP1613922)
Enumeration Date
2007-02-14
Last Update Date
2007-07-08
Business Address
-- JUDITH JACKSON ARNP
13856 N DALE MABRY HWY
TAMPA, FL 33618-2420
Phone number: 813-264-1885
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Mailing Address
-- JUDITH JACKSON ARNP
4212 GOLF CLUB LN
TAMPA, FL 33618-2728
Phone number: 813-964-9565
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