Provider Demographics
NPI:1295540557
Name:JURAS, TANEESHA SUSANNE (DC)
Entity type:Individual
Prefix:
First Name:TANEESHA
Middle Name:SUSANNE
Last Name:JURAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 VICKSBURG ST
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-2636
Mailing Address - Country:US
Mailing Address - Phone:608-576-8259
Mailing Address - Fax:
Practice Address - Street 1:547 E NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724-6081
Practice Address - Country:US
Practice Address - Phone:386-734-1404
Practice Address - Fax:386-308-4960
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH15372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor