Individual
DR. JASMINE ROSE JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
620 10TH ST N, ST PETERSBURG, FL 33705-1407
(727) 824-8243
(727) 824-8233
Mailing address
620 10TH ST N STE 2A, ST PETERSBURG, FL 33705-1407
(727) 824-8243
(727) 824-8233
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME126616
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018755400
—
FL
Enumeration date
05/22/2012
Last updated
03/31/2022
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