Jacob, Leslie
Jacob, Leslie is an sole proprietor health care provider with primary practice located at 4200 Sun N Lake Blvd , Sebring FL 33872-1986. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Jacob, Leslie can be contacted via phone (863) 402-3103.Contact Information
Primary practice address
4200 Sun N Lake Blvd
Sebring FL 33872-1986
Phone: (863) 402-3103
Fax: (863) 402-5339
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 0101280924 | Virginia |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | ME66002 | Florida |
Profile Details
| NPI number | 1679647697 |
|---|---|
| LBN Legal business name | Jacob, Leslie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Apr 16th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679647697 | NPPES |
| Florida | MEDICAID | 119868200 | |
| Florida | Other | RM822 | |
| Florida | Other | 100011557 | |
| Florida | Other | 28906 |
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