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Trevor Jackson, DO
Student in an Organized Health Care Education/Training Program in South Miami, Florida
NPI 1245812452

Trevor Jackson is a Student in an Organized Health Care Education/Training Program based in South Miami, FL. Trevor Jackson practices in South Miami, FL and has the professional credentials of DO. The NPI Number for Trevor Jackson is 1245812452 and holds a License No. OS20575 (Florida).

The current practice location address for Trevor Jackson is 7031 Sw 62Nd Ave, South Miami, FL and can be reached out via phone at 305-284-1776.

Location: 7031 Sw 62Nd Ave, South Miami, FL, 33143-4701
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245812452
Provider Name
Trevor Jackson
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
7031 Sw 62Nd Ave, South Miami, FL, 33143-4701
Phone Number
305-284-1776
Fax Number
Provider Enumeration Date
04/27/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
7031 Sw 62Nd Ave
City
South Miami
State
Florida
Zip
33143-4701
Phone Number
305-284-1776
Fax Number
person
Provider Business Mailing Address Details
Address
7031 Sw 62Nd Ave
City
South Miami
State
Florida
Zip
33143-4701
Phone Number
305-284-1776
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
OS20575 (Florida)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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