Provider Demographics
NPI:1891921581
Name:TRUYOU PLASTIC SURGERY OF JACKSONVILLE PLLC
Entity Type:Organization
Organization Name:TRUYOU PLASTIC SURGERY OF JACKSONVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EREZ
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:STERNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-434-8100
Mailing Address - Street 1:7711 BAYMEADOWS RD E
Mailing Address - Street 2:SUITE #6
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9675
Mailing Address - Country:US
Mailing Address - Phone:904-638-5555
Mailing Address - Fax:
Practice Address - Street 1:7711 BAYMEADOWS RD E
Practice Address - Street 2:SUITE #6
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9675
Practice Address - Country:US
Practice Address - Phone:904-638-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88836208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty