# DR. JACOB SMALL, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr. Jacob Small, Professional Association
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649516030
- **Authorized official:** JACOB SMALL (PRESIDENT)
- **Authorized official phone:** (305) 972-2614

## Contact information

- **Practice address:** 13805 SW 78TH CT, PALMETTO BAY, FL 33158-1109
- **Practice address phone:** (305) 972-2614
- **Mailing address:** 13805 SW 78TH CT, PALMETTO BAY, FL 33158-1109
- **Mailing address phone:** (305) 972-2614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 2163832 | FL | Yes |

## Other

- **Enumeration date:** 12/13/2012
- **Last updated:** 05/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 304943400 | — | FL |