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

Evita B Henderson-Jackson, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1578752598

Evita B Henderson-Jackson, MD is a Pathology in Tampa, Florida. Qualified in 2001, 25 years ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
25
Licensed in
FL
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone: (813) 745-7487
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence ME104658 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence TRN9826 (FL)

Record details

NPI number1578752598
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 16, 2007
Last updated in NPPESMay 15, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc — 1135 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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