Individual
LATASHA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3831 SW 31ST CT, WEST PARK, FL 33023-5744
(754) 230-2585
Mailing address
3831 SW 31ST CT, WEST PARK, FL 33023-5744
(754) 230-2585
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
332U00000X
Home Delivered Meals
—
—
342000000X
Transportation Network Company
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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