Healthcare Provider Details

I. General information

NPI: 1013757475
Provider Name (Legal Business Name): JULIA AFFRONTI MS, CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2024
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 NATURE WALK PKWY UNIT 108
ST AUGUSTINE FL
32092-3065
US

IV. Provider business mailing address

14175 PIER LN
JACKSONVILLE FL
32224-7002
US

V. Phone/Fax

Practice location:
  • Phone: 904-328-7489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ11916
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: