Healthcare Provider Details

I. General information

NPI: 1528460888
Provider Name (Legal Business Name): JULIE STEELE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2014
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 AVENUE B SE
WINTER HAVEN FL
33880-3037
US

IV. Provider business mailing address

150 AVENUE B SE
WINTER HAVEN FL
33880-3037
US

V. Phone/Fax

Practice location:
  • Phone: 863-294-1429
  • Fax: 863-294-9826
Mailing address:
  • Phone: 863-294-1429
  • Fax: 863-294-9826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ6841
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: