Healthcare Provider Details

I. General information

NPI: 1386567535
Provider Name (Legal Business Name): JULIANA VALCOURT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9021 PARK ROYAL DR
FORT MYERS FL
33908-9617
US

IV. Provider business mailing address

3411 26TH ST W
LEHIGH ACRES FL
33971-5251
US

V. Phone/Fax

Practice location:
  • Phone: 239-432-5858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number11049596
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: