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General NPI Number Information
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NPI Number | 1942692256
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Entity Type | Organization
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Legal Business Name | PIUS JACOB MD
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 38188 MEDICAL CENTER AVE
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540-1380
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Country | US
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Telephone | 813-783-3736
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Fax |
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Provider Business Mailing Address
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Address Line | 38188 MEDICAL CENTER AVE
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City | ZEPHYRHILLS
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State | FL
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Zip | 33540-1380
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Country | US
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Telephone | 813-783-3736
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | DR. PIUS JACOB
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Credential |
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Telephone | 813-783-3736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME51553
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License Number State | FL
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