Provider Demographics
NPI:1609238658
Name:JACOBS, BETH SINGER (DO)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:SINGER
Last Name:JACOBS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ERIN
Other - Last Name:SINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 SE 14TH ST
Mailing Address - Street 2:STE 1B
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1852
Mailing Address - Country:US
Mailing Address - Phone:954-467-3878
Mailing Address - Fax:954-467-7571
Practice Address - Street 1:255 SE 14TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1852
Practice Address - Country:US
Practice Address - Phone:954-467-3878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine