IndividualActive
Carol Jackson, OTA
NPI 1386370351 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Ocklawaha, FL
Provider details
- NPI number
- 1386370351
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- OTA
- Sex
- Female
- Sole proprietor
- Yes
- License
- FLOTA8013 (FL)
Specialties & taxonomies
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081S0010XLicense FLOTA8013 (FL)
Allopathic & Osteopathic Physicians
Practice location
10710 Se 160th Court Rd
Ocklawaha, FL 32179-8906
Phone: (352) 750-6619
Approximate (ZIP-level) locationGet directions
Mailing address
10710se160th Ct Rd
Ocklawaha, FL 32179
Registry dates
- Enumerated
- 2022-08-01
- Last updated
- 2022-08-01
- Certified
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.