Individual
MITCHELL JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1995 E OAKLAND PARK BLVD STE 310, FORT LAUDERDALE, FL 33306-1138
(954) 791-6146
Mailing address
PO BOX 936535, ATLANTA, GA 31193-6535
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9117133
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9117133
FL
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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