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Organization

BELLIAMINOWA JACKSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BELLIAMINOWA JACKSON M.D (PEDIATRICIAN)
(786) 484-0088
Entity
Organization

Contact information

Practice address
17761 SW 2ND ST, PEMBROKE PINES, FL 33029-3924
(786) 484-0088
(786) 484-0190
Mailing address
17761 SW 2ND ST, PEMBROKE PINES, FL 33029-3924
(786) 484-0088
(786) 484-0190

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME87240
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
278195600
FL
Enumeration date
08/11/2014
Last updated
08/11/2014
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