Provider Demographics
NPI:1265589956
Name:JACKSON-NIIQUAYE, TERRI AMINAH (MD)
Entity type:Individual
Prefix:DR
First Name:TERRI
Middle Name:AMINAH
Last Name:JACKSON-NIIQUAYE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:904-450-6063
Mailing Address - Fax:904-539-4091
Practice Address - Street 1:615 N BONITA AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3623
Practice Address - Country:US
Practice Address - Phone:850-769-1511
Practice Address - Fax:850-416-6159
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2025-02-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME1715532086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care