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General NPI Number Information
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NPI Number | 1982010674
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Entity Type | Individual
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Provider Name | JOSHUAH JACKSON
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Gender | Female
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2601 W LAKE MARY BLVD STE 129
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City | LAKE MARY
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State | FL
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Zip | 32746-3567
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Country | US
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Telephone | 407-502-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 4409 HOFFNER AVE # 258
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City | ORLANDO
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State | FL
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Zip | 32812-2331
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Country | US
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Telephone | 407-502-9111
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Fax | 855-947-2792
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 3478
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License Number State | FL
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