Organization
ACTIVE INNOVATIONS
Active
Other names
KeyMed
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN K JACOBS (OWNER/PRESIDENT)
(904) 541-0207
Entity
Organization
Contact information
Practice address
1892 BELLAIR BLVD, ORANGE PARK, FL 32073-4548
(904) 541-0207
(904) 269-8373
Mailing address
1892 BELLAIR BLVD, ORANGE PARK, FL 32073-4548
(904) 541-0207
(904) 269-8373
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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