Healthcare Provider Details

I. General information

NPI: 1851219802
Provider Name (Legal Business Name): ERIC KRUEGER APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 UNIVERSITY BLVD S STE 221
JACKSONVILLE FL
32216-4392
US

IV. Provider business mailing address

3901 UNIVERSITY BLVD S STE 221
JACKSONVILLE FL
32216-4392
US

V. Phone/Fax

Practice location:
  • Phone: 904-423-0010
  • Fax:
Mailing address:
  • Phone: 904-423-0010
  • Fax: 904-423-0012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberAPRN11048954
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: