Jackson, Iris

Jackson, Iris is an sole proprietor health care provider with primary practice located at 8175 Nw 12Th St Suite 306, Doral FL 33126-1828. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jackson, Iris can be contacted via phone (786) 845-0173.

Contact Information

Primary practice address
8175 Nw 12Th St Suite 306 Doral FL 33126-1828
Phone: (786) 845-0173
Fax: (305) 470-5846
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP 1563532 Florida

Profile Details

NPI number 1518053313
LBN Legal business name Jackson, Iris
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2006
Last updated May 13th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518053313 NPPES
Florida MEDICAID 001398500

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