Lauren Ricchiuti-Jackson
Family Medicine in Bradenton, FL. Individual provider (NPI-1).
NPI number1164042966
StatusActive
Last updated in NPPESJul 10, 2024
Details
- NPI
- 1164042966
- Entity type
- Individual (NPI-1)
- Name
- Lauren Ricchiuti-Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2020
- Certification date
- Aug 21, 2023
- Last updated
- Jul 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | os19939 | FL | Yes |
Practice location
5123 4th Avenue Cir EBradenton, FL 34208-5620
Phone 941-744-5510
Mailing address
5123 4th Avenue Cir EBradenton, FL 34208-5620
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