Blum, Jacob

Blum, Jacob is an individual health care provider with primary practice located at 1888 S 14Th St Credentialing Department, Fernandina Beach FL 32034-3054. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blum, Jacob can be contacted via phone (904) 261-0922.

Contact Information

Primary practice address
1888 S 14Th St Credentialing Department Fernandina Beach FL 32034-3054
Phone: (904) 261-0922
Fax: (904) 277-8872
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 28306 Kentucky
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME60766 Florida

Profile Details

NPI number 1720047137
LBN Legal business name Blum, Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Dec 31st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720047137 NPPES
Florida Other P01374253 RR MEDICARE

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