Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackson Reef

Organization Health Service Clinic/Center · NPI 1396398608

Jackson Reef is a Health Service Clinic/Center in Ormond Beach, Florida. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019

Practice location Address checks out

495 S Nova Rd Ste 101A
Ormond Beach, FL 32174-8444
Phone: (386) 487-4673
Fax: (855) 829-5770
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 851 Dunlawton Ave Ste 103, Port Orange, FL 32127-4234 — (386) 487-4673

Specialties & licences

Health Service Clinic/Center (primary) Taxonomy 261QH0100X

Record details

NPI number1396398608
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official William Self — Owner · (386) 487-4673
Other names Life Is Ketaful
NPI enumeratedJuly 17, 2019
Last updated in NPPESAugust 7, 2020
Certification dateAugust 7, 2020
Mailing address495 S Nova Rd Ste 101a, Ormond Beach, FL 32174-8444

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