MEDICARE: MR. FLORENS JULIEN

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	390200000X	Student in an Organized Health Care Education/Training Program
2	252Y00000X	Early Intervention Provider Agency		FL

General Provider Information

NPI Number	:	1225260961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FLORENS JULIEN

Provider Business Mailing Address
First Line	:	1300 NW 192ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-3443
Country	:	US
Telephone Number	:	305-710-1876
Fax Number	:	786-320-5933

Provider Business Practice Location Address
First Line	:	1300 NW 192ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-3443
Country	:	US
Telephone Number	:	305-710-1876
Fax Number	:

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

Provider Enumeration Date	:	08/13/2009
Last Update Date	:	07/13/2020

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