Elias C Jacobo, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME44908 Issued in FL

Practice address

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-5595

Phone

(321) 868-5871

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1275696437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 WEST SR 434 SUITE 302",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503275",
            "telephone_number": "407-332-0777",
            "fax_number": "407-332-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W COCOA BEACH CSWY",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329315595",
            "telephone_number": "321-868-5871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "515 West SR 434 Suite 302",
            "address_purpose": "LOCATION",
            "city": "Longwood",
            "state": "FL",
            "postal_code": "327503275",
            "country_code": "US",
            "telephone_number": "407-332-0777",
            "fax_number": "407-332-8767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBO",
        "first_name": "ELIAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME44908",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME44908",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME44908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022594600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - FL",
            "identifier": "08258V",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• James C Elmer, MD PA
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• Emily G Jennings, PA-C
• Aaron Jiron

• Specialist in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.