1903 E FLETCHER AVE
TAMPA, FL 33612-3713 US PECOS Enrolled
Mashira Denisha Jackson-Gallegos
Family Medicine Physician
- TAMPA, FL
- Phone: (813)-344-1084
- Last Updated 11/23/2022
Overview
Mashira Denisha Jackson-Gallegos is a Family Medicine Physician in the TAMPA area. Mashira Denisha Jackson-Gallegos primary office location is at 1903 E FLETCHER AVE and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1639373509 and the information was updated approximately 2 years ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| 141452 | NC |
| ME 108584 | FL |
| Type/Issuer | Identifier | State |
|---|---|---|
| NC TRAINING LICENSE | 141452 | NC |
| Taxonomy | State | Primary? |
|---|---|---|
| Family Medicine Physician - Taxonomy Code 207Q00000X | FL | Y |
| Family Medicine Physician - Taxonomy Code 207Q00000X | NC | N |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | |
| PECOS Individual PAC ID: | |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | Yes |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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