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

Sandina Samantha Jackson, APRN

Individual provider Nurse Practitioner · NPI 1225623408

Sandina Samantha Jackson, APRN is a Nurse Practitioner in Pembroke Pines, Florida. Qualified in 2020, 6 years ago. Practices with Conviva Medical Center Management, LLC, a 562-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida, Georgia, North Carolina and Pennsylvania and 1 more.

Years since qualifying
6
Licensed in
FL, GA, NC, PA, SC
In the registry since
2021
Specialties on file
5
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

880 SW 145th Ave Ste 202
Pembroke Pines, FL 33027-6171
Phone: (866) 849-0692
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1000 36th St, Vero Beach, FL 32960-4862 — (772) 567-4311

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN11010356 (FL)
Nurse Practitioner Taxonomy 363L00000X · Licence 5023920 (NC)
Nurse Practitioner Taxonomy 363L00000X · Licence GAA-NP004965 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence 31804 (SC)
Nurse Practitioner Taxonomy 363L00000X · Licence SP035423 (PA)

Record details

NPI number1225623408
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorNo
NPI enumeratedMarch 9, 2021
Last updated in NPPESMay 19, 2026
Certification dateMay 19, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Conviva Medical Center Management, Llc — 562 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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