Organization
MY FAMILY DOCTOR, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARNIKA RENEE JACKSON (PRESIDENT/OFFICE MANAGER)
(305) 705-6688
Entity
Organization
Contact information
Practice address
111 NW 183RD ST STE 306, MIAMI, FL 33169-4599
(305) 705-6688
Mailing address
111 NW 183RD ST STE 306, MIAMI, FL 33169-4599
(305) 705-6688
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME37656
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184607541
—
FL
Enumeration date
05/23/2018
Last updated
05/23/2018
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