Provider Demographics
NPI:1528016375
Name:JURCIK, YVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:
Last Name:JURCIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 LAKE WORTH RD
Mailing Address - Street 2:# 204
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4727
Mailing Address - Country:US
Mailing Address - Phone:561-968-7968
Mailing Address - Fax:561-964-4603
Practice Address - Street 1:140 JFK DR
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6608
Practice Address - Country:US
Practice Address - Phone:561-968-6767
Practice Address - Fax:561-641-0814
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-34781052084N0400X
FLME995892084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL03061672Medicaid
FL279840900Medicaid
IL03061672Medicaid
FL279840900Medicaid
FLAG536ZMedicare PIN