# JACOB HLAVACH

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1811325913
- **Gender:** Man
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA9107443 | FL | Yes |

## Other

- **Enumeration date:** 10/29/2013
- **Last updated:** 08/01/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4913847 | AETNA | FL |
| 01 | — | 5712135 | CIGNA | FL |
| 01 | — | P01374271 | RR MEDICARE | FL |
| 01 | — | P1020872 | FREEDOM | FL |
| 01 | — | P959331 | OPTIMUM | FL |