Organization
DANIEL M JACOBS MD PA
Active
Other names
Propathmed LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL M JACOBS MD (OWNER)
(954) 895-2862
Entity
Organization
Contact information
Practice address
458 W HILLSBORO BLVD, DEERFIELD BEACH, FL 33441-1604
(954) 895-2862
(414) 607-3946
Mailing address
2200 NORTH MAYFAIR ROAD, SUITE 200, WAUWATOSA, WI 53226-2252
(414) 258-9511
(414) 607-3946
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800025654
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00921513
RR MEDICARE
FL
Enumeration date
06/15/2009
Last updated
08/03/2011
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