Individual
FARRELL EUGENE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 NW 172ND TER, MIAMI GARDENS, FL 33169-5305
(305) 620-3533
Mailing address
850 NW 172ND TER, MIAMI GARDENS, FL 33169-5305
(305) 620-3533
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
RT10376
FL
Other
Enumeration date
07/11/2010
Last updated
07/11/2010
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