Basic Information
| Provider Information | |||||||||
| NPI: | 1992186761 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARUZ | ||||||||
| FirstName: | JEYKO | ||||||||
| MiddleName: | JOELLE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23343 NW COUNTY ROAD 236 | ||||||||
| Address2: | |||||||||
| City: | HIGH SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326439669 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3464540698 | ||||||||
| FaxNumber: | 3864540690 | ||||||||
| Practice Location | |||||||||
| Address1: | 911 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | TRENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326933239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3524632374 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2015 | ||||||||
| LastUpdateDate: | 09/09/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | LL38493 | SC | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | ME134843 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.