Individual ProviderNatasha Monique JacksonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address11000 Prosperity Farms Rd Ste 203, Palm Beach Gardens, FL 33410-3462(561) 432-0111PECOS EnrollmentBased on the most recent information from CMS, provider Natasha Monique Jackson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1659784320Provider TypeIndividualFull NameJackson, Natasha MoniqueCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date6/10/2014Last Updated6/10/2014Contact InformationPractice LocationPractice Address11000 Prosperity Farms Rd Ste 203, Palm Beach Gardens, FL 33410-3462Phone(561) 432-0111FaxUnlisted FaxMailing LocationMailing Address11000 Prosperity Farms Rd Ste 203, Palm Beach Gardens, FL 33410-3462Phone(561) 432-0111FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT 29279Florida