Radim Jacob
Internal Medicine in Orange Park, FL. Individual provider (NPI-1).
NPI number1669935128
StatusActive
Last updated in NPPESAug 2, 2022
Details
- NPI
- 1669935128
- Entity type
- Individual (NPI-1)
- Name
- Radim Jacob
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 11, 2019
- Certification date
- Jul 22, 2022
- Last updated
- Aug 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | ME155370 | FL | Yes |
Practice location
2001 Kingsley AveOrange Park, FL 32073-5156
Phone 904-639-2000 · Fax 904-639-2015
Mailing address
1592 Porter Lakes DrJacksonville, FL 32218-9047
Phone 904-316-4972
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