Jackson, Monica D

Jackson, Monica D is an individual health care provider with primary practice located at 5270 Babcock St Ne Ste 1 , Palm Bay FL 32905-4616. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jackson, Monica D can be contacted via phone (321) 722-5959.

Contact Information

Primary practice address
5270 Babcock St Ne Ste 1 Palm Bay FL 32905-4616
Phone: (321) 722-5959
Fax: (321) 722-5960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 005585 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9113041 Florida

Profile Details

NPI number 1548583719
LBN Legal business name Jackson, Monica D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 2nd, 2010
Last updated Apr 25th, 2022 - about 2 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 1548583719 NPPES
Florida MEDICAID 105825900

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