MEDICARE: DR. KAREN TALPINS JACOBS M.D.

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	2085R0202X	Diagnostic Radiology Physician	ME72779	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	06491	OTHER	FL	AM.BOARD/NUCLEAR MEDICINE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	ME72779	OTHER	FL	MEDICAL LICENSE #
4	44678	OTHER		AM. BOARD OF RADIOLOGY

General Provider Information

NPI Number	:	1255380564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN TALPINS JACOBS M.D.

Provider Business Mailing Address
First Line	:	11041 PINE LODGE TRL
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33328-7317
Country	:	US
Telephone Number	:	954-474-8099
Fax Number	:	954-474-8099

Provider Business Practice Location Address
First Line	:	6619 S DIXIE HWY
Second Line	:	SUITE #165
City	:	MIAMI
State	:	FL
Zip	:	33143-7919
Country	:	US
Telephone Number	:	305-220-2273
Fax Number	:	305-559-6569

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2006
Last Update Date	:	03/07/2023

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