Jacob, Leslie

Jacob, Leslie is an sole proprietor health care provider with primary practice located at 4200 Sun N Lake Blvd , Sebring FL 33872-1986. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Jacob, Leslie can be contacted via phone (863) 402-3103.

Contact Information

Primary practice address
4200 Sun N Lake Blvd Sebring FL 33872-1986
Phone: (863) 402-3103
Fax: (863) 402-5339
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 0101280924 Virginia
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X ME66002 Florida

Profile Details

NPI number 1679647697
LBN Legal business name Jacob, Leslie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2006
Last updated Apr 16th, 2024 - about last year

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 1679647697 NPPES
Florida MEDICAID 119868200
Florida Other RM822
Florida Other 100011557
Florida Other 28906

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