Individual
DR. ELIAS C JACOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-5595
(321) 868-5871
Mailing address
515 WEST SR 434 SUITE 302, LONGWOOD, FL 32750-3275
(407) 332-0777
(407) 332-8767
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME44908
FL
208800000X
Urology Physician
ME44908
FL
208M00000X
Hospitalist Physician
ME44908
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022594600
—
FL
01
—
08258V
MEDICARE - FL
FL
Enumeration date
12/19/2006
Last updated
11/20/2020
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