JACKSON MEDICAL ENTERPRISE NPI 1023463429

NPI Information

NPI: 1023463429
Provider Name: JACKSON MEDICAL ENTERPRISE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
4800 ASTON GARDENS WAY
MEDICAL DIRECTOR'S OFFICE
NAPLES, FL
ZIP 34109
Phone: (239) 330-1301
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JACKSON MEDICAL ENTERPRISE is a primary care clinic center in Naples, FL. JACKSON MEDICAL ENTERPRISE NPI is 1023463429. The provider is registered as an organization entity type.

The provider's business location address is:

4800 ASTON GARDENS WAY
MEDICAL DIRECTOR'S OFFICE
NAPLES, FL
ZIP 34109-501
Phone: (239) 330-1301

The provider's authorized official is Malia M Jackson Rodriguez .
The authorized official title is Owner and has the following contact phone number (239) 207-0948.

The enumeration date for this NPI number is 5/4/2016 and was last updated on 5/4/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		ME 104632	FLORIDA	No
2	314000000X	Skilled Nursing Facility		ME 104632	FLORIDA	No
3	261QP2300X	Clinic/Center	Primary Care	ME 104632	FLORIDA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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