Jackson, Larry

Jackson, Larry is an sole proprietor health care provider with primary practice located at 1501 5Th Ave N , St Petersburg FL 33705-2008. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Research Study, Technologists, Technicians & Other Technical Service Providers / Technician, Other. Other Service Providers / Research Study is his primary health care specialty. Jackson, Larry can be contacted via phone (727) 896-8686.

Contact Information

Primary practice address
1501 5Th Ave N St Petersburg FL 33705-2008
Phone: (727) 896-8686
Fax: (727) 898-9596
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Research Study 1744R1102X
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X

Profile Details

NPI number 1679971667
LBN Legal business name Jackson, Larry
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 8th, 2014
Last updated Dec 8th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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