Organization
JACOB & JACOB MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIREILLE COLES MD (PHYSICIAN)
(954) 564-8542
Entity
Organization
Contact information
Practice address
2101 NE 26TH STREET, FORT LAUDERDALE, FL 33305
(954) 564-8542
(954) 564-3364
Mailing address
2101 NE 26TH ST, WILTON MANORS, FL 33305-1535
(954) 564-8542
(954) 564-3364
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME34383
FL
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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