Healthcare Provider Details

I. General information

NPI: 1285919233
Provider Name (Legal Business Name): JULIA N KHALIL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2011
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33175
US

IV. Provider business mailing address

3705 HOLLYWOOD BLVD
HOLLYWOOD FL
33021
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-1960
  • Fax:
Mailing address:
  • Phone: 954-962-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS45393
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20499
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: