Individual
LESLIE JACOB
Active
Individual
LESLIE JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
0101280924
VA
207RG0100X
Gastroenterology Physician
Primary
ME66002
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100011557
RAILROAD MEDICARE
FL
05
—
119868200
—
FL
01
—
28906
BLUE CROSS BLUE SHIELD OF FLA
FL
01
—
RM822
HFMG MA
FL
Enumeration date
11/20/2006
Last updated
04/16/2024
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