Healthcare Provider Details

I. General information

NPI: 1669436010
Provider Name (Legal Business Name): JULIA JUNCO-MARANTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 SW 30TH AVE SUITE 101
POMPANO BEACH FL
33069-4887
US

IV. Provider business mailing address

7111 FAIRWAY DR SUITE 400
PALM BEACH GARDENS FL
33418-4204
US

V. Phone/Fax

Practice location:
  • Phone: 954-633-3387
  • Fax:
Mailing address:
  • Phone: 561-712-6265
  • Fax: 561-712-7349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberME52922
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: