Provider Demographics
NPI:1417908435
Name:JURADO, MIGUEL (MD)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:
Last Name:JURADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000-2 LEM TURNER ROAD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208
Mailing Address - Country:US
Mailing Address - Phone:904-539-8200
Mailing Address - Fax:904-539-8229
Practice Address - Street 1:8000-2 LEM TURNER ROAD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208
Practice Address - Country:US
Practice Address - Phone:904-539-8200
Practice Address - Fax:904-539-8229
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162602207R00000X
GA041853208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0007065498Medicaid
GAP00337029OtherRAILROAD MEDICARE
GA949593-09859OtherBLUE CROSS BLUE SHIELD
GA11SCGBVMedicare PIN
GA949593-09859OtherBLUE CROSS BLUE SHIELD