Provider Demographics
NPI:1881683308
Name:JACKSON CURTIS, DANUTA THERESA (MD)
Entity Type:Individual
Prefix:MRS
First Name:DANUTA
Middle Name:THERESA
Last Name:JACKSON CURTIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:28960 US HIGHWAY 19 N
Mailing Address - Street 2:STE. 115
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2403
Mailing Address - Country:US
Mailing Address - Phone:727-771-8282
Mailing Address - Fax:727-771-8788
Practice Address - Street 1:28960 US HIGHWAY 19 N
Practice Address - Street 2:STE. 115
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2403
Practice Address - Country:US
Practice Address - Phone:727-771-8282
Practice Address - Fax:727-771-8788
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2022-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME61310208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA85309Medicare UPIN