Jackson, Teresa A

Jackson, Teresa A is an individual health care provider with primary practice located at 20612 Nw 27Th Ave , Miami Gardens FL 33056-1469. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Jackson, Teresa A can be contacted via phone (305) 637-6400.

Contact Information

Primary practice address
20612 Nw 27Th Ave Miami Gardens FL 33056-1469
Phone: (305) 637-6400
Fax: (305) 636-5155
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2904542 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2904542 Florida

Profile Details

NPI number 1528160181
LBN Legal business name Jackson, Teresa A
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2006
Last updated Apr 28th, 2026 - about 6 months 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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Identifiers

StateTypeNumberIssuer
All States NPI 1528160181 NPPES
Florida MEDICAID 021212500

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