Healthcare Provider Details

I. General information

NPI: 1821933482
Provider Name (Legal Business Name): JULIA DURSO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 GRAND AVE APT 7114
PINELLAS PARK FL
33782-6246
US

IV. Provider business mailing address

3110 GRAND AVE APT 7114
PINELLAS PARK FL
33782-6246
US

V. Phone/Fax

Practice location:
  • Phone: 859-358-5294
  • Fax:
Mailing address:
  • Phone: 859-358-5294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11046239
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: