MEDICARE: JANET HURLBURT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME83476	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083697858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET HURLBURT MD

Provider Business Mailing Address
First Line	:	3611 EGRET DR
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-8151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3611 EGRET DR
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-8151
Country	:	US
Telephone Number	:	321-956-1127
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	03/18/2008

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