Provider Demographics
NPI:1851683742
Name:AUERBACH, JENA (DO)
Entity Type:Individual
Prefix:DR
First Name:JENA
Middle Name:
Last Name:AUERBACH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:JENA
Other - Middle Name:
Other - Last Name:PION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10912 NW 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-5459
Mailing Address - Country:US
Mailing Address - Phone:352-363-6562
Mailing Address - Fax:
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:352-376-1611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5736207ZD0900X
NY60 255523207ZD0900X
FLOS12982207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL019122000Medicaid
FL019122000Medicaid