Individual
DR. MARIKA LAUREN COLLYMORE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
630 JACKSONVILLE DR, JACKSONVILLE BEACH, FL 32250-3814
(904) 323-0954
Mailing address
630 JACKSONVILLE DR, JACKSONVILLE BEACH, FL 32250-3814
(904) 323-0954
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO4497
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO4497
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/06/2021
Last updated
08/23/2025
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