Healthcare Provider Details

I. General information

NPI: 1285408328
Provider Name (Legal Business Name): JULIA JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 SW 3RD ST
POMPANO BEACH FL
33060-6934
US

IV. Provider business mailing address

1800 ORCHARD DR
ARNOLD MO
63010-2459
US

V. Phone/Fax

Practice location:
  • Phone: 954-224-5350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: