Provider Demographics
NPI:1699505685
Name:JURENOVICH, ERIC ANTHONY
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:ANTHONY
Last Name:JURENOVICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 A1A N STE 212
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-5702
Mailing Address - Country:US
Mailing Address - Phone:904-608-1445
Mailing Address - Fax:904-395-2421
Practice Address - Street 1:166 A1A N STE 212
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-5702
Practice Address - Country:US
Practice Address - Phone:904-608-1445
Practice Address - Fax:904-395-2421
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care