Krill-Jackson, Elisa

Krill-Jackson, Elisa is an individual health care provider with primary practice located at 1475 Nw 12Th Ave Fl 32 , Miami FL 33136-1002. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology & Oncology, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Hematology & Oncology is her primary health care specialty. Krill-Jackson, Elisa can be contacted via phone (305) 243-5302.

Contact Information

Primary practice address
1475 Nw 12Th Ave Fl 32 Miami FL 33136-1002
Phone: (305) 243-5302
Fax: (305) 243-9161
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 0066352 Florida
Other Service Providers / Specialist 174400000X ME66352 Florida
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X ME66352 Florida

Profile Details

NPI number 1427046085
LBN Legal business name Krill-Jackson, Elisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2005
Last updated Oct 31st, 2019 - about 5 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 1427046085 NPPES
Florida MEDICAID 272074400

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