Provider Demographics
NPI:1598310211
Name:JURA-PIERRE, MYRTHA (MD)
Entity Type:Individual
Prefix:
First Name:MYRTHA
Middle Name:
Last Name:JURA-PIERRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:M
Other - Last Name:PIERRE-JURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13099 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-2608
Mailing Address - Country:US
Mailing Address - Phone:954-629-4667
Mailing Address - Fax:
Practice Address - Street 1:2412 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-3724
Practice Address - Country:US
Practice Address - Phone:954-289-0000
Practice Address - Fax:305-751-1507
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1194208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice