SearchFlorida172A00000X

Patrice Jackson

NPI 1689589905 · on the registry since 2026 · sole proprietor

Practice

Address
1925 Avenue O Sw Unit 104
Winter Haven, FL 33880
Phone
(863) 662-8896

Registry record

Primary taxonomy
172A00000X
172A00000X
Licence states on file
FL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-08-19

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