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Organization
ACTIVE LIVING MEDICAL CENTER
Active
Organization
ACTIVE LIVING MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JODI L JAKIEL (OWNER)
(407) 384-4904
Entity
Organization
Contact information
Practice address
8257 NARCOOSSEE PARK DR STE 516, ORLANDO, FL 32822-5545
(407) 384-4904
Mailing address
8257 NARCOOSSEE PARK DR STE 516, ORLANDO, FL 32822-5545
(407) 616-6279
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
06/22/2021
Last updated
06/24/2021
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