Individual
LALITHA E JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6229 66TH ST N, PINELLAS PARK, FL 33781-5025
(727) 528-1888
(727) 528-0586
Mailing address
6229 66TH ST N, PINELLAS PARK, FL 33781-5025
(727) 528-1888
(727) 528-0586
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME62238
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250587800
—
FL
01
—
31517
BLUE CROSS
FL
Enumeration date
08/25/2006
Last updated
07/18/2011
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