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NPI Code Detail

MEDICARE: JACKLYN POTTS

MEDICARE: JACKLYN POTTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramNAFL

General Provider Information

NPI Number : 1134062870
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACKLYN POTTS
Provider Business Mailing Address
First Line : 5440 LINTON BLVD
Second Line : DELRAY MEDICAL CENTER - FAIR OAKS PAVILION #247
City : DELRAY BEACH
State : FL
Zip : 33484-6512
Country : US
Telephone Number : 561-334-6240
Fax Number : 561-495-3467
Provider Business Practice Location Address
First Line : 5352 LINTON BLVD
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33484-6514
Country : US
Telephone Number : 561-498-4440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/09/2026

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Directions to “ JACKLYN POTTS ” Practice Location

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