Healthcare Provider Details

I. General information

NPI: 1821186230
Provider Name (Legal Business Name): JULIE KONOWITZ SIRKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9868 S STATE ROAD 7 STE 305
BOYNTON BEACH FL
33472-4475
US

IV. Provider business mailing address

160 JFK DR STE 101
ATLANTIS FL
33462-6638
US

V. Phone/Fax

Practice location:
  • Phone: 561-369-0111
  • Fax: 561-369-4003
Mailing address:
  • Phone: 561-964-1215
  • Fax: 561-964-1245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number84037
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: