MEDICARE: JACOBO ELGOZY M.D.P.A

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	OS-10059	FL

General Provider Information

NPI Number	:	1073741963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACOBO ELGOZY M.D.P.A

Provider Business Mailing Address
First Line	:	2350 N UNIVERSITY DR # 840736
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33024-3614
Country	:	US
Telephone Number	:	646-401-2389
Fax Number	:	305-357-1678

Provider Business Practice Location Address
First Line	:	7191 TAFT ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-3805
Country	:	US
Telephone Number	:	646-401-2389
Fax Number	:	305-357-1678

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JACOBO ELGOZY
Credential	:	DO
Telephone Number	:	646-401-2389

Provider Enumeration Date	:	06/30/2009
Last Update Date	:	06/26/2023

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