Ivey, Jacob

Ivey, Jacob is an individual health care provider with primary practice located at 15815 Shaddock Dr Ste 130 , Winter Garden FL 34787-5773. He recently has 4 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Ivey, Jacob can be contacted via phone (407) 605-2321.

Contact Information

Primary practice address
15815 Shaddock Dr Ste 130 Winter Garden FL 34787-5773
Phone: (407) 605-2321
Fax: (407) 671-4155
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO4464 Florida
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X PO4464 Florida
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO4464 Florida
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X PO4464 Florida

Profile Details

NPI number 1891374302
LBN Legal business name Ivey, Jacob
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2021
Last updated Jun 12th, 2024 - about 6 months 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 1891374302 NPPES
Florida Other YC4QH BCBS FL BLUE
Florida Other 16150857 BCBS FL BLUE

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