Organization
PUTNAM FAMILY CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY JACOBSON M.D. (VP)
(386) 326-1225
Entity
Organization
Contact information
Practice address
6101 CRILL AVE, PALATKA, FL 32177-3875
(386) 326-1225
Mailing address
6101 CRILL AVE, PALATKA, FL 32177-3875
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
54QP00053
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267777600
—
FL
Enumeration date
07/29/2006
Last updated
07/16/2013
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