Small, Jacob

Small, Jacob is an sole proprietor health care provider with primary practice located at 13805 Sw 78Th Ct , Palmetto Bay FL 33158-1109. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Allopathic & Osteopathic Physicians / Surgery. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Small, Jacob can be contacted via phone (305) 972-2614.

Contact Information

Primary practice address
13805 Sw 78Th Ct Palmetto Bay FL 33158-1109
Phone: (305) 972-2614
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP2163832 Florida
Allopathic & Osteopathic Physicians / Surgery 208600000X ME51250 Florida

Profile Details

NPI number 1477550176
LBN Legal business name Small, Jacob
Credentials PHD, ARNP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2005
Last updated May 9th, 2024 - about 7 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 1477550176 NPPES
Florida MEDICAID 304943400

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