Provider Demographics
NPI:1306588629
Name:VERA-JACKSON, MONICA SABRINA (DC)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:SABRINA
Last Name:VERA-JACKSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11600 IRVING AVE
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-7002
Mailing Address - Country:US
Mailing Address - Phone:813-317-7092
Mailing Address - Fax:
Practice Address - Street 1:11600 IRVING AVE
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-7002
Practice Address - Country:US
Practice Address - Phone:813-317-7092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor