Organization
JACOB JOSEPH M.D., P.A.
Active
Other names
MANATEE ORTHOPAEDIC AND SPORTS MEDICINE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB JOSEPH M.D., P.A. (OWNER)
(941) 746-1662
Entity
Organization
Contact information
Practice address
2820 MANATEE AVE W, BRADENTON, FL 34205-4237
(941) 746-1662
(941) 747-4394
Mailing address
PO BOX 15179, BRADENTON, FL 34280-5179
(941) 746-1662
(941) 747-4394
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
ME46458
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40943
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/22/2006
Last updated
11/26/2007
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