Provider Demographics
NPI:1518165737
Name:ELGOZY, JACOBO (DO)
Entity Type:Individual
Prefix:DR
First Name:JACOBO
Middle Name:
Last Name:ELGOZY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7191 TAFT ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3805
Mailing Address - Country:US
Mailing Address - Phone:954-639-7258
Mailing Address - Fax:305-357-1678
Practice Address - Street 1:7191 TAFT ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-3805
Practice Address - Country:US
Practice Address - Phone:954-639-7258
Practice Address - Fax:305-357-1678
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS-10059208000000X
FLOS10059207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics