PUTNAM FAMILY CARE, INC.
Ambulatory Health at Crill Ave, Palatka, FL

License number
Florida 54QP00053
Category
Ambulatory Health
Type
Urgent Care
Owner
Name: JERRY JACOBSON M.D.
Title: VP
Phone: (386) 326-1225
Address
Address
6101 Crill Ave, Palatka, FL 32177
National Provider ID: 1205840519
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PUTNAM FAMILY CARE, INC

6101 Crill Ave, Palatka, FL 32177

Registration:
Jun 27, 2002
State ID:
P02000071069
Business type:
Florida Profit Corporation
S:
Derek S Bohn, 6101 Crill Ave, Palatka, FL 32177 (Physical),Jerry Jacobson, 6101 Crill Ave, Palatka, FL 32177 (Physical)
Agent:
Derek Bohn,6101 Crill Ave, Palatka, FL 32177 (Physical)
FEI/EIN:
81-0559052

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