Organization
MEDICAL IMAGING & THERAPEUTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK D JACOBSON MD (SOLE MEMBER)
(352) 267-1963
Entity
Organization
Contact information
Practice address
769 HIGHWAY 466, SUITE 769, LADY LAKE, FL 32159-6340
(352) 261-5502
(480) 247-4206
Mailing address
922 SHORE ACRES DR, LEESBURG, FL 34748-9269
(352) 267-1963
(480) 247-4206
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
02/14/2013
Last updated
02/14/2013
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