Organization
COMPREHENSIVE VASCULAR DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN K JACOBS (DIRECTOR)
(904) 541-0207
Entity
Organization
Contact information
Practice address
1892 BELLAIR BLVD, ORANGE PARK, FL 32073-4548
(904) 541-0207
(904) 264-2067
Mailing address
1892 BELLAIR BLVD, ORANGE PARK, FL 32073-4548
(904) 541-0207
(904) 264-2067
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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