Healthcare Provider Details

I. General information

NPI: 1225404486
Provider Name (Legal Business Name): ERUM JIVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3310 SW 34TH ST
OCALA FL
34474-7422
US

IV. Provider business mailing address

4170 SW 47TH CT
OCALA FL
34474-9231
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-0707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number9334098
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9334098
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: