Individual
RANDALL S JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9800 S HEALTHPARK DR STE 110, FORT MYERS, FL 33908-3630
(239) 343-6202
(239) 343-4159
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-6202
(239) 343-4159
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
4301406898
MI
207RG0100X
Gastroenterology Physician
Primary
ME164131
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120521000
—
FL
Enumeration date
11/21/2005
Last updated
09/26/2025
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