Individual
CHRISTOPHER THOMAS JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STUDENT
Contact information
Practice address
1000 WATERMAN WAY, TAVARES, FL 32778-5266
(352) 253-3333
Mailing address
812 HANDSOME CAB LN APT 104, MELBOURNE, FL 32940-8252
(407) 375-7856
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11006614
FL
Other
Enumeration date
10/19/2019
Last updated
04/21/2020
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