Mr. Keith R Jackson
Occupational Therapist
600 North Blvd W Suite D
Leesburg
, Florida 34748-5063
Mr. Keith R Jackson
Occupational Therapist
600 North Blvd W Suite D
Leesburg
, Florida 34748-5063
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About
Features
Specialties
- Occupational Therapist
Languages spoken
- English
Location
First Address
- Mr. Keith R Jackson
- 4024 Eagle Ridge Rd
- Fruitland Park, FL
- Zip : 34731-5619
- Phone :
Second Address
- Mr. Keith R Jackson
- 600 North Blvd W Suite D
- Leesburg, FL
- Zip : 34748-5063
- Phone : (352) 787-9300
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OT9471 | FL |
National Provider Identifier
| NPI | 1003009937 |
|---|---|
| Provider Name | Mr. Keith R Jackson |
| First Address | Fruitland Park, FL 34731-5619 |
| Second Address | Leesburg, FL 34748-5063 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/08/2007 |
| Last Update Date | 23/08/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.