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General NPI Number Information
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NPI Number | 1073785499
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Entity Type | Organization
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Legal Business Name | SAMUEL S JACOBSON MD PA
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Dates
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Enumeration Date | 03/26/2008
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Last Update Date | 09/20/2010
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Provider Practice Location Address
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Address Line | 1601 CLINT MOORE RD SUITE 175
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City | BOCA RATON
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State | FL
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Zip | 33487-5713
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Country | US
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Telephone | 561-939-5770
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Fax | 561-939-5775
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Provider Business Mailing Address
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Address Line | 1601 CLINT MOORE RD SUITE 175
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City | BOCA RATON
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State | FL
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Zip | 33487-2768
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Country | US
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Telephone | 561-939-5770
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Fax | 561-939-5775
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SAMUEL S JACOBSON
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Credential | M.D.
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Telephone | 561-939-0200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME32787
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License Number State | FL
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