KRISTIN M JACKSON LLC (NPI# 1649748666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649748666 |
| Entity Type | Organization |
| Organization Name | KRISTIN M JACKSON LLC |
| Other Organization Name | ADVANCED UROGYNECOLOGY |
| Practice Address |
260 Lookout Pl Ste 201 Maitland FL 32751-4485 |
| Practice Telephone | 4078989804 |
| Practice Fax Number | 4078989805 |
| Mailing Telephone | 4078989804 |
| Mailing Fax Number | 4078989805 |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-12-26 |
| Authorized Official Name | DR. KRISTIN JACKSON (OWNER) |
| Authorized Official Telephone | 4079027400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Advanced Urogynecology | Doing Business As Name - Organization |
| Street Address |
260 LOOKOUT PL STE 201 |
| City | MAITLAND |
| State | FL |
| Zip Code | 32751-4485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134731748 | Lindsey Cieslak | Nurse Practitioner | 260 Lookout Pl Ste 201, Maitland, FL 32751-4485 | 2020-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891302899 | Compassionate Care Psychiatry | Psychiatry & Neurology | 1717 Goldveiw Drive, Maitland, FL 32751 | 2020-09-24 |
| 1437763497 | Allstar Kids Behavioral Services, Inc | Counselor | 467 Lake Howell Rd Suite 102, Maitland, FL 32751 | 2020-09-06 |
| 1003428269 | Cmg- New Season- St. Louis Metro Treatment Center | Counselor | 2500 Maitland Center Parkway 250, Maitland, FL 32751 | 2020-08-19 |
| 1821616228 | Katherine Tchir | Anesthesiologist Assistant | 851 Trafalgar Court Suite 200e, Maitland, FL 32751 | 2020-07-12 |
| 1699309518 | Karin Scotchie | Occupational Therapist | 1700 Monroe Rd, Maitland, FL 32751 | 2020-02-29 |
| 1184255929 | Counseling Specialists, Inc. | Counselor | 610 N. Wymore Rd., Suite 110, Maitland, FL 32751 | 2020-01-30 |
| 1427528074 | Auricular Health Center | Clinic/Center | 237 Lookout Place, Maitland, FL 32751 | 2018-11-27 |
| 1710456181 | Yadiel Munoz | Counselor | 5786, 225 S Swoope Ave # 211, Maitland, FL 32751 | 2018-11-15 |
| 1780152678 | Rebecca Hernandez | Case Manager/Care Coordinator | 1000 Winderley Pl Unit 221, Maitland, FL 32751 | 2018-11-08 |
| 1548742901 | David Cromer | Social Worker | 225 S. Swoope Ave #211, Maitland, FL 32751 | 2018-09-02 |
| Find all providers in zip 32751 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910240 | Jeffrey M Greenberg Md Medical Services Inc | Obstetrics & Gynecology | 13324 Pond Apple Dr W, Naples, FL 34119-8556 | 2020-10-20 |
| 1497365464 | Hamel Foundation Inc | Obstetrics & Gynecology | 7777 N University Dr Ste 206, Tamarac, FL 33321-6106 | 2020-08-05 |
| 1336786466 | Manfred Emil Trostel | Obstetrics & Gynecology | 2425 Gulf of Mexico Dr Unit 8d, Longboat Key, FL 34228-3213 | 2019-12-09 |
| 1790335164 | Customized Wellness, LLC | Obstetrics & Gynecology | 131 W Center Avenue, Sebring, FL 33870 | 2019-09-17 |
| 1649737552 | Joe Walker Bancroft Jr. | Obstetrics & Gynecology | 4618 Long Bow Rd. South, Jacksonville, FL 32210-8144 | 2019-02-27 |
| 1710476239 | Yvette Pereyra Ans | Obstetrics & Gynecology | 3990 Sheridan St Ste 214, Hollywood, FL 33021-3656 | 2018-05-10 |
| 1194223800 | Vandyke Md Ob/gyn Pa | Obstetrics & Gynecology | 9161 Narcoossee Rd Ste B209, Orlando, FL 32827-5764 | 2018-01-28 |
| 1538676515 | Adam Ostrzenski | Obstetrics & Gynecology | 7001 Central Ave Ste 3, St Petersburg, FL 33710-7549 | 2017-12-29 |
| 1144735945 | Judith Watson Bradfield | Obstetrics & Gynecology | 8024 Links Way, Port St Lucie, FL 34986-3035 | 2017-12-04 |
| 1073069159 | Caceres Specialized Gynecology, LLC | Obstetrics & Gynecology | 1530 Celebration Blvd, Suite 408, Suite 408, Celebration, FL 34747-4970 | 2016-08-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.