Provider Demographics
NPI:1124394341
Name:LANDES, JACOB S (DO)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:S
Last Name:LANDES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9970 CENTRAL PARK BLVD N STE 300
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-2237
Mailing Address - Country:US
Mailing Address - Phone:561-488-2200
Mailing Address - Fax:561-488-1064
Practice Address - Street 1:9970 CENTRAL PARK BLVD N STE 300
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428-2237
Practice Address - Country:US
Practice Address - Phone:561-488-2200
Practice Address - Fax:561-488-1064
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 14144207X00000X, 207XS0106X
FLOS14144207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery