Individual
DR. PAUL ALLEN JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4044 W LAKE MARY BLVD, #410, LAKE MARY, FL 32746-2012
(407) 718-8000
Mailing address
4044 W LAKE MARY BLVD, #410, LAKE MARY, FL 32746-2012
(407) 718-8000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
38737
FL
2084P0804X
Child & Adolescent Psychiatry Physician
ME38737
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040565500
—
FL
Enumeration date
02/14/2007
Last updated
02/17/2012
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