Individual
MR. JACKIE DARRELL RATLIFF JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
Mailing address
11950 RUDDY RUN, ODESSA, FL 33556-4096
(727) 514-0451
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
11008066
FL
Other
Enumeration date
09/02/2021
Last updated
04/17/2023
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