Individual provider · NPI-1

Alyssa Jackson

Technician, Attendant Care Provider · Ocoee, FL

NPI number1992533996
StatusActive
Last updated in NPPESJul 23, 2024

Details

NPI
1992533996
Entity type
Individual (NPI-1)
Name
Alyssa Jackson
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 23, 2024
Certification date
Jul 23, 2024
Last updated
Jul 23, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3747A0650X Technician, Attendant Care Provider––Yes

Practice location

2416 Greenwood Oak Dr
Ocoee, FL 34761-5156

Phone 727-235-1346

Mailing address

2416 Greenwood Oak Dr
Ocoee, FL 34761-5156

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