Provider Demographics
NPI:1396706966
Name:JUGAN, MICHAEL MONROE (DO)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MONROE
Last Name:JUGAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3210 CLEVELAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-7180
Mailing Address - Country:US
Mailing Address - Phone:239-936-6778
Mailing Address - Fax:239-936-6905
Practice Address - Street 1:3210 CLEVELAND AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7180
Practice Address - Country:US
Practice Address - Phone:239-936-6778
Practice Address - Fax:239-936-6905
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0006104207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054677100Medicaid
FL0905257OtherUNITED HEALTHCARE
FL80505OtherBCBS
FL0664623OtherAETNA HMO
FL4198735OtherAETNA PPO
FL6100549OtherGHI
FL2416393001OtherCIGNA
FLE95412Medicare UPIN
FL2416393001OtherCIGNA
FL0664623OtherAETNA HMO
FL0626040002Medicare NSC