Healthcare Provider Details

I. General information

NPI: 1578761052
Provider Name (Legal Business Name): JEFFREY ALLEN SZURMINSKI RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 SAXON BLVD
ORANGE CITY FL
32763-8468
US

IV. Provider business mailing address

314 RACHELLE AVE APT 1032
SANFORD FL
32771-7910
US

V. Phone/Fax

Practice location:
  • Phone: 386-917-5557
  • Fax:
Mailing address:
  • Phone: 407-324-5910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN9169380
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: