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NPI Code Detail

MEDICARE: JULIE MERGL, INC.

MEDICARE: JULIE MERGL, INC.
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
1261QM0850XAdult Mental Health Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11427299320OTHERFLNPI

General Provider Information

NPI Number : 1568018133
Entity Type Code : Organization
Provider Name (Legal Business Name) : JULIE MERGL, INC.
Provider Business Mailing Address
First Line : 3895 TAR KILN RD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32223-2097
Country : US
Telephone Number : 904-366-9617
Fax Number : 904-886-4017
Provider Business Practice Location Address
First Line : 6100 GREENLAND RD STE 302
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32258-2626
Country : US
Telephone Number : 904-366-9617
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MS. JULIE D MERGL
Credential : LMHC
Telephone Number : 904-466-1253
Provider Enumeration Date : 08/10/2019
Last Update Date : 02/27/2020

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