Provider Demographics
NPI:1518599984
Name:JURDEN, TOWANDA
Entity Type:Individual
Prefix:
First Name:TOWANDA
Middle Name:
Last Name:JURDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 SANDRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-4488
Mailing Address - Country:US
Mailing Address - Phone:407-421-0298
Mailing Address - Fax:
Practice Address - Street 1:2404 SANDRIDGE CIR
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-4488
Practice Address - Country:US
Practice Address - Phone:407-421-0298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)