Healthcare Provider Details

I. General information

NPI: 1629991575
Provider Name (Legal Business Name): JULIAN JARAMILLO III
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14236 OASIS COVE BLVD UNIT 3204
WINDERMERE FL
34786-6803
US

IV. Provider business mailing address

14236 OASIS COVE BLVD UNIT 3204
WINDERMERE FL
34786-6803
US

V. Phone/Fax

Practice location:
  • Phone: 910-478-7725
  • Fax:
Mailing address:
  • Phone: 910-478-7725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: