Healthcare Provider Details

I. General information

NPI: 1497018006
Provider Name (Legal Business Name): JULIA NEMIROFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 10/07/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 RCA BLVD STE 112
PALM BEACH GARDENS FL
33410-3337
US

IV. Provider business mailing address

2560 RCA BLVD STE 112
PALM BEACH GARDENS FL
33410-3337
US

V. Phone/Fax

Practice location:
  • Phone: 561-331-1797
  • Fax: 561-331-1797
Mailing address:
  • Phone: 561-331-1797
  • Fax: 561-331-5073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME131906
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME131906
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: