# JACKSON CLINIC CENTER, INC.

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

## Provider details

- **NPI number:** 1821223959
- **Authorized official:** RODOLFO A CASTILLO (PRESIDENT)
- **Authorized official phone:** (786) 234-5699

## Contact information

- **Practice address:** 8770 SW 72ND ST \# 307, MIAMI, FL 33173-3512
- **Practice address phone:** (786) 234-5699
- **Practice address fax:** (702) 549-9256
- **Mailing address:** 8770 SW 72ND ST \# 307, MIAMI, FL 33173-3512
- **Mailing address phone:** (786) 234-5699
- **Mailing address fax:** (702) 549-9256

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2009
- **Last updated:** 05/19/2009