Healthcare Provider Details

I. General information

NPI: 1003010794
Provider Name (Legal Business Name): JULIO C SOKOLICH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15211 VANOWEN ST STE 208
VAN NUYS CA
91405-3623
US

IV. Provider business mailing address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

V. Phone/Fax

Practice location:
  • Phone: 818-782-3255
  • Fax: 818-782-7026
Mailing address:
  • Phone: 352-265-0680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberC145272
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: