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Individual

DR. JONATHAN RUSSELL JAGID

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1475 NW 12TH AVE., MIAMI, FL 33136
(305) 243-6946
(305) 243-3337
Mailing address
1095 NW 14TH TERRACE, MIAMI, FL 33136
(305) 243-6946
(305) 243-3337

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
ME70068
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2617366-00
FL
05
261736600
FL
Enumeration date
07/17/2006
Last updated
02/07/2017
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