Healthcare Provider Details

I. General information

NPI: 1871168013
Provider Name (Legal Business Name): JULIETA ARISTIZABAL BARON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2021
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12 AVENUE, WW-279
MIAMI FL
33136
US

IV. Provider business mailing address

1611 NW 12 AVENUE, WW-279
MIAMI FL
33136
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-8178
  • Fax: 305-585-5743
Mailing address:
  • Phone: 305-585-8178
  • Fax: 305-585-5743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: