Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | ME0057657 | FL |
NPI | 1366400467 |
---|---|
Provider Name | Michael Harris Jacobs |
First Address | Miami, FL 33176-2197 |
Second Address | Miami, FL 33176-2144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A51584 | (02) | FL |