MEDICARE: DR. STEVEN JACOBSON DC

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	111N00000X	Chiropractor	CH3555	FL

General Provider Information

NPI Number	:	1295080059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN JACOBSON DC

Provider Business Mailing Address
First Line	:	10140 NW 13 STREET
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1395 W SUNRISE BLVD
Second Line	:	SUITE 1
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-7076
Country	:	US
Telephone Number	:	954-616-5849
Fax Number	:

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

Provider Enumeration Date	:	07/18/2012
Last Update Date	:	07/18/2012

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