Provider Demographics
NPI:1912999632
Name:JACOBS, STEPHEN F (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:F
Last Name:JACOBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1912
Mailing Address - Country:US
Mailing Address - Phone:954-701-2580
Mailing Address - Fax:954-565-7234
Practice Address - Street 1:2500 N ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-1912
Practice Address - Country:US
Practice Address - Phone:954-701-2580
Practice Address - Fax:954-565-7234
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0036236207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease