Individual
DR. BRUCE MITCHELL YERGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3627 UNIVERSITY BLVD S STE 300, JACKSONVILLE, FL 32216
(904) 396-0300
(904) 396-3039
Mailing address
1361 13TH AVE S STE 245, JACKSONVILLE BEACH, FL 32250-3238
(904) 396-0300
(904) 396-3039
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME0021067
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0098365-00
FL MEDICAID - GROUP
FL
05
—
0141594-00
—
FL
01
—
215889
AVMED
FL
01
—
5362087
AETNA
FL
01
—
78027
BLUE CROSS BLUE SHIELD
FL
01
—
GR172A
MEDICARE - GROUP
FL
01
—
PO1615058
RR MEDICARE
FL
Enumeration date
09/20/2005
Last updated
05/21/2025
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