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Organization

JACKSON CORRECTIONAL INSTITUTION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT FLORES (WARDEN)
(850) 569-5260
Entity
Organization

Contact information

Practice address
5563 10TH ST, MALONE, FL 32445-3129
(850) 569-5260
(850) 569-1013
Mailing address
5563 10TH ST, MALONE, FL 32445-3129
(850) 569-5260
(850) 569-1013

Taxonomy

Speciality
Code
Description
License number
State
261QP2400X
Prison Health Clinic/Center
Primary
ARNP 1812192
FL

Other

Enumeration date
12/07/2007
Last updated
12/07/2007
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