Provider Demographics
NPI:1255342333
Name:JURKOVICH, DAVID F (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:JURKOVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 N UNIVERSITY DR STE 204
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-0929
Mailing Address - Country:US
Mailing Address - Phone:954-962-7200
Mailing Address - Fax:954-893-5936
Practice Address - Street 1:1779 N UNIVERSITY DR
Practice Address - Street 2:SUITE 204
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-0929
Practice Address - Country:US
Practice Address - Phone:954-962-7200
Practice Address - Fax:954-893-5936
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80911207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL261873700Medicaid
FL261873700Medicaid