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Organization
DR. JACOB SMALL, PA
Active
Organization
DR. JACOB SMALL, PA
Active
Other names
Dr. Jacob Small, Professional Association
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB SMALL (PRESIDENT)
(305) 972-2614
Entity
Organization
Contact information
Practice address
13805 SW 78TH CT, PALMETTO BAY, FL 33158-1109
(305) 972-2614
Mailing address
13805 SW 78TH CT, PALMETTO BAY, FL 33158-1109
(305) 972-2614
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2163832
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304943400
—
FL
Enumeration date
12/13/2012
Last updated
05/09/2024
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