Healthcare Provider Details

I. General information

NPI: 1902074511
Provider Name (Legal Business Name): JULIE D BRUNO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2008
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2421 HOLLYWOOD BLVD STE 2
HOLLYWOOD FL
33020-6605
US

IV. Provider business mailing address

20775 NE 32ND PL
AVENTURA FL
33180-3652
US

V. Phone/Fax

Practice location:
  • Phone: 954-881-1129
  • Fax: 954-923-9111
Mailing address:
  • Phone: 954-881-1129
  • Fax: 954-923-9190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY7670
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberPY 7670
License Number StateFL

VIII. Authorized Official

Name: DR. JULIE D BRUNO
Title or Position: PSYCHOLOGIST
Credential: PSY.D
Phone: 954-881-1129