Individual
DR. AMY MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2731 MAGUIRE RD, OCOEE, FL 34761-4797
(407) 635-3080
(407) 636-7804
Mailing address
2731 MAGUIRE RD, OCOEE, FL 34761-4797
(407) 635-3080
(407) 636-7804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS9293
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009067700
—
FL
Enumeration date
06/20/2006
Last updated
11/07/2019
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