Healthcare Provider Details

I. General information

NPI: 1114835915
Provider Name (Legal Business Name): TOBY JACKNIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TOVA SCHWARTZ

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7998 PALACIO DEL MAR DR
BOCA RATON FL
33433-4148
US

IV. Provider business mailing address

7998 PALACIO DEL MAR DR
BOCA RATON FL
33433-4148
US

V. Phone/Fax

Practice location:
  • Phone: 862-704-9813
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberN37004-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: