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Organization

DR. JACOB SMALL, PA

Active
Other names
Dr. Jacob Small, Professional Association
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB SMALL (PRESIDENT)
(305) 972-2614
Entity
Organization

Contact information

Practice address
13805 SW 78TH CT, PALMETTO BAY, FL 33158-1109
(305) 972-2614
Mailing address
13805 SW 78TH CT, PALMETTO BAY, FL 33158-1109
(305) 972-2614

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2163832
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
304943400
FL
Enumeration date
12/13/2012
Last updated
05/09/2024
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