MEDICARE: JULIANN CLEMENTE PA-C

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	363AM0700X	Medical Physician Assistant	0110009852	VA
2	363A00000X	Physician Assistant	0110009852	VA

General Provider Information

NPI Number	:	1881466464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANN CLEMENTE PA-C

Provider Business Mailing Address
First Line	:	510 SUNSET VIEW TER SE UNIT 301
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20175-6183
Country	:	US
Telephone Number	:	803-546-5225
Fax Number	:

Provider Business Practice Location Address
First Line	:	11800 SUNRISE VALLEY DR STE 800
Second Line	:
City	:	RESTON
State	:	VA
Zip	:	20191-5320
Country	:	US
Telephone Number	:	703-709-1114
Fax Number	:

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

Provider Enumeration Date	:	10/26/2023
Last Update Date	:	07/16/2024

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Directions to “ JULIANN CLEMENTE PA-C” Practice Location

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