Provider Demographics
NPI:1184072357
Name:JUERGENS, RICHARD (HAD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:JUERGENS
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 BRICKELL AVE STE N1700
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3105
Mailing Address - Country:US
Mailing Address - Phone:786-563-4010
Mailing Address - Fax:
Practice Address - Street 1:2344 BUTANO DR STE C3
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0617
Practice Address - Country:US
Practice Address - Phone:916-265-4510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8111237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist