DR. KENNETH MICHAEL JACOB


Address: 19460 Caladesi Dr, Fort Myers, FL 33967-5572
Phone: 9137070826

DR. KENNETH MICHAEL JACOB (NPI# 1437121829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437121829
Entity Type Individual
Full Name DR. KENNETH MICHAEL JACOB
Credential MD
Practice Address 19460 Caladesi Dr
Fort Myers
FL 33967-5572
Mailing Address 19460 Caladesi Dr
Apt/suite
Fort Myers
FL 33967-5572
Practice Telephone 9137070826
Mailing Telephone 9137070826
Mailing Fax Number 4177727019
Enumeration Date 2006-02-01
Last Update Date 2013-11-13
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0202X Radiology
Specialization: Diagnostic Radiology
R3D70 MO Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
BCBS 12485021 01
KS 100154570D 05
MO 203728035 05

Other Providers KENNETH JACOB

NPI Name Taxonomy Address Enumeration
1174780183 Kenneth William Jacob Counselor 680 Park Ave W, Mansfield, OH 44906-3706 2008-05-19

Office Location

Street Address 19460 CALADESI DR
City FORT MYERS
State FL
Zip Code 33967-5572

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235614991 Michelle Lynn Gerken Nurse Practitioner 8141 Pennsylvania Blvd, Fort Myers, FL 33967 2018-09-28
1659892370 Mary Kathryn Mckeon Occupational Therapist 9025 King Rd W, Ft Myers, FL 33967 2017-07-03
1316321003 Wal-mart Stores East, Lp Technician/Technologist 19975 S Tamiami Trail, Fort Myers, FL 33967 2015-07-13
1104970409 Jennifer J. Paul Registered Nurse 17132 Alico Center Road, Suite 1, Fort Myers, FL 33967 2007-01-23
1194750935 William A. Greider Dentist 19004 Birch Rd. Se, Ft. Myers, FL 33967 2006-07-11
1548271869 Desiree Granados-fischel Obstetrics & Gynecology 19348 La Serena Dr, Fort Myers, FL 33967-0525 2006-08-11
1487644555 Henry Donn Venable Anesthesiology 19324 La Serena Dr, Estero, FL 33967-0525 2005-10-28
1407146434 Barrie Nicole Vilnius Occupational Therapist 8815 Largo Mar Dr, Fort Myers, FL 33967-0534 2011-04-11
1760805725 Hearing Health In Home Care, LLC Hearing Instrument Specialist 19760 Maddelena Cir, Fort Myers, FL 33967-0537 2014-01-28
1891110128 Derick Alexander Winn Hearing Instrument Specialist 19760 Maddelena Cir, Fort Myers, FL 33967-0537 2014-02-24
Find all providers in zip 33967

Taxonomy Information

Taxonomy Code 2085R0202X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Diagnostic Radiology

Taxonomy Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1669997961 Sw Florida Radiology LLC Radiology 3949 Evans Ave Ste 301b, Fort Myers, FL 33901-9313 2017-08-08
1346698669 Irving Radiology, Inc Radiology 4110 Center Pointe Dr Ste 210, Fort Myers, FL 33916 2016-05-26
1851752257 Lillian Palmon Radiology 11250 Mahogany Run, Fort Myers, FL 33913-8114 2016-03-11
1770739260 Winston Dacosta Irving Radiology 1244 Walden Dr, Fort Myers, FL 33901 2008-08-15
1366646424 Louis Thomas Magas Radiology 6311 South Pointe Blvd, Fort Myers, FL 33919-4901 2007-06-13
1851330153 David S Schwartz Radiology 3230 Cypress Marsh Dr, Fort Myers, FL 33905-6250 2006-06-05
1851345862 Otto J Kunst Radiology 13151 Parkline Dr, Fort Myers, FL 33913-7929 2006-05-22
1124078241 Adam Fueredi Radiology 3660 Broadway, Fort Myers, FL 33901-8005 2006-05-11
1235187808 Gail M Santucci Radiology 8791 Conference Dr, Suite 1, Fort Myers, FL 33919-5822 2006-05-05
1538121116 Laurie Lynn Gutstein Radiology 6013 W Riverside Dr, Fort Myers, FL 33919-1636 2006-04-06
Find all providers in FORT MYERS

Competitor

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City FORT MYERS
Zip Code 33967

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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