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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