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General NPI Number Information
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NPI Number | 1326301136
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Entity Type | Individual
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Provider Name | JAKUB SROUBEK MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | CLEVELAND CLINIC 9500 EUCLID AVENUE / J2-2
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-1715
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Fax | 216-636-6978
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Provider Business Mailing Address
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Address Line | BETH ISRAEL DEACONESS MEDICAL CENTER 330 BROOKLINE AVENUE
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City | BOSTON
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State | MA
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Zip | 02215
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Country | US
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Telephone | 617-667-8800
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Fax | 617-632-7620
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 261698
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 35.138501
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License Number State | OH
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