MEDICARE: DR. JACOB W. AARONSON D.O., M.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	2083C0008X	Clinical Informatics Physician	0102201600	VA
2	207Q00000X	Family Medicine Physician	0102201600	VA

General Provider Information

NPI Number	:	1710957444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB W. AARONSON D.O., M.A.

Provider Business Mailing Address
First Line	:	1722 SHERIDAN ST # 245
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-2275
Country	:	US
Telephone Number	:	407-316-9292
Fax Number	:	703-783-0099

Provider Business Practice Location Address
First Line	:	1722 SHERIDAN ST # 245
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-2275
Country	:	US
Telephone Number	:	240-731-6929
Fax Number	:	703-783-0099

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	10/27/2020

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