MEDICARE: DANIEL HARRY 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	2084N0400X	Neurology Physician	ME0063521	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	130020568	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	42335	OTHER	FL	BLUECROSS BLUESHIELD
4	3246418-010	OTHER	FL	CIGNA

General Provider Information

NPI Number	:	1356323166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL HARRY JACOBS M.D.

Provider Business Mailing Address
First Line	:	3849 OAKWATER CIRCLE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806
Country	:	US
Telephone Number	:	407-240-1762
Fax Number	:	407-812-5869

Provider Business Practice Location Address
First Line	:	3849 OAKWATER CIRCLE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806
Country	:	US
Telephone Number	:	407-240-1762
Fax Number	:	407-812-5869

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	11/01/2010

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