# PREVENTATIVE HEALTHCARE MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124586243
- **Authorized official:** THEONA A JACKSON APRN (PRESIDENT)
- **Authorized official phone:** (954) 471-3500

## Contact information

- **Practice address:** 7342 NW 48TH ST, LAUDERHILL, FL 33319-3401
- **Practice address phone:** (954) 471-3500
- **Mailing address:** 7342 NW 48TH ST, LAUDERHILL, FL 33319-3401
- **Mailing address phone:** (954) 471-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2019
- **Last updated:** 03/07/2019