Individual
DR. JACOB K AGAMASU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
731 STIRLING CENTER PL UNIT 1911, LAKE MARY, FL 32746-5209
(407) 804-9616
(407) 804-8331
Mailing address
731 STIRLING CENTER PL UNIT 1911, LAKE MARY, FL 32746-5209
(407) 804-9616
(407) 804-8331
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME85101
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13045
BC
FL
Enumeration date
05/10/2006
Last updated
11/20/2024
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