Healthcare Provider Details

I. General information

NPI: 1710803192
Provider Name (Legal Business Name): FRITZ S JULES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15395 N MIAMI AVE
MIAMI FL
33169-6736
US

IV. Provider business mailing address

15395 N MIAMI AVE
MIAMI FL
33169-6736
US

V. Phone/Fax

Practice location:
  • Phone: 305-896-4528
  • Fax:
Mailing address:
  • Phone: 305-896-4528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11036973
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number11036973
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11036973
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: