Individual
DR. JORDAN VAN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4016 SUN CITY CENTER BLVD, SUN CITY CENTER, FL 33573-5256
(813) 634-3301
Mailing address
10762 PLEASANT KNOLL DR, TAMPA, FL 33647-3667
(713) 447-0122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS20918
FL
207RI0200X
Infectious Disease Physician
Primary
OS20918
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2019
Last updated
08/08/2025
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