Individual
BRIAN MICHAEL JURBALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3317 US HIGHWAY 98 S STE 9, LAKELAND, FL 33803-8316
(863) 709-8777
(863) 709-1060
Mailing address
3317 US HIGHWAY 98 S STE 9, LAKELAND, FL 33803-8316
(863) 709-8777
(863) 709-1060
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME70116
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020593810
GROUP # FOR TRICARE
FL
01
—
200046088
RAILROAD MEDICARE
FL
01
—
264652800
PROVIDER # FOR TRICARE
FL
Enumeration date
09/21/2005
Last updated
07/10/2024
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