Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO 3810 | FL |
NPI | 1013340025 |
---|---|
Provider Name | Dr. Jacob Bartoszek |
First Address | Lake Mary, FL 32746-4802 |
Second Address | Lake Mary, FL 32746-4802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2013 |
Last Update Date | 21/04/2017 |