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General NPI Number Information
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NPI Number | 1497373823
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Entity Type | Individual
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Provider Name | EUGENE HURST LPN
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Gender | Male
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 1515 INDIAN RIVER BLVD STE A236
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City | VERO BEACH
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State | FL
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Zip | 32960-7110
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Country | US
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Telephone | 772-242-4596
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Fax |
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Provider Business Mailing Address
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Address Line | 715 61ST AVE
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City | VERO BEACH
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State | FL
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Zip | 32968-9258
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Country | US
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Telephone | 772-453-7315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN5192137
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License Number State | FL
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