Jacobson, Paul Allen

Jacobson, Paul Allen is an sole proprietor health care provider with primary practice located at 4044 W Lake Mary Blvd #410, Lake Mary FL 32746-2012. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Jacobson, Paul Allen can be contacted via phone (407) 718-8000.

Contact Information

Primary practice address
4044 W Lake Mary Blvd #410 Lake Mary FL 32746-2012
Phone: (407) 718-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 38737 Florida
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X ME38737 Florida

Profile Details

NPI number 1821131780
LBN Legal business name Jacobson, Paul Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 14th, 2007
Last updated Feb 17th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821131780 NPPES
Florida MEDICAID 040565500

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