Provider Demographics
NPI:1861505125
Name:JURGENS, MARIA CATHERINE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CATHERINE
Last Name:JURGENS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:CATHERINE
Other - Last Name:LIATSOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 628219
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32862-8219
Mailing Address - Country:US
Mailing Address - Phone:800-477-1283
Mailing Address - Fax:
Practice Address - Street 1:5352 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484
Practice Address - Country:US
Practice Address - Phone:561-498-4440
Practice Address - Fax:561-495-3103
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9168144367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered