Individual
DR. JON STEPHEN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2419 E COMMERCIAL BLVD STE 100, FORT LAUDERDALE, FL 33308
(954) 771-9120
(954) 771-4883
Mailing address
2419 E COMMERCIAL BLVD STE 100, FORT LAUDERDALE, FL 33308-4042
(954) 771-9120
(954) 581-5496
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC0000951
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084148000
—
FL
Enumeration date
08/18/2005
Last updated
06/29/2018
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