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Mrs. Jade Jackson, LDO
Optician in Palm Coast, Florida
NPI 1679630842

Jade Jackson is a Optician based in Palm Coast, FL and is specialized in Optician. Jade Jackson practices in Palm Coast, FL and has the professional credentials of LDO. The NPI Number for Jade Jackson is 1679630842 and holds a License No. DO5189 (Florida).

The current practice location address for Jade Jackson is 1240 Palm Coast Pkwy Sw, Palm Coast, FL and can be reached out via phone at 386-446-4210 and via fax at 386-445-7309.

Location: 1240 Palm Coast Pkwy Sw, Palm Coast, FL, 32137-4700
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679630842
Provider Name
Jade Jackson
Credential
LDO
Provider Entity Type
Individual
Gender
Female
Address
1240 Palm Coast Pkwy Sw, Palm Coast, FL, 32137-4700
Phone Number
386-446-4210
Fax Number
386-445-7309
Provider Enumeration Date
01/03/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
OP0463 01 FL EYE-MED
630073100 05 FL
institution
Provider Business Practice Location Address Details
Address
1240 Palm Coast Pkwy Sw
City
Palm Coast
State
Florida
Zip
32137-4700
Phone Number
386-446-4210
Fax Number
386-445-7309
person
Provider Business Mailing Address Details
Address
1240 Palm Coast Pkwy Sw
City
Palm Coast
State
Florida
Zip
32137-4700
Phone Number
386-446-4210
Fax Number
386-445-7309
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
DO5189 (Florida)
Definition
Definition to come...
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