Individual
MR. JACOB PUTKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1368 N UNIVERSITY DR, PLANTATION, FL 33322-4734
(954) 577-0001
Mailing address
5229 N DIXIE HWY, APT 29C2, OAKLAND PARK, FL 33334-4028
(203) 300-9224
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
027832
NY
363A00000X
Physician Assistant
Primary
PA9107020
FL
Other
Enumeration date
02/01/2013
Last updated
01/28/2022
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