Leon Jackson, COTA/L

NPI 1396120911 · on the registry since 2015 · sole proprietor

Practice

Address: 601 S Semoran Blvd
Orlando, FL 32807
Phone: (321) 368-2172
Organisation at this address: Semoran Pharmacy Inc
Gutierrez Medical Center, Llc
Doctors' Pain Management Associates, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 6

Registry record

Primary taxonomy: 224Z00000X
224Z00000X
Licence states on file: FL
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2015-07-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida