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General NPI Number Information
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NPI Number | 1053258681
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Entity Type | Organization
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Legal Business Name | DRUG ENFORCEMENT ADMINISTRATON
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 2295 EAST IRLO BROSON HWY 180
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City | APO
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State | AA
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Zip | 34747
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Country | US
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Telephone | 305-609-0024
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Fax |
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Provider Business Mailing Address
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Address Line | 2295 EAST IRLO BROSON HWY 180
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City | APO
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State | AA
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Zip | 34747
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Country | US
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Telephone | 305-609-0024
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Fax |
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Authorized Official
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Title or Position | SAC
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Name | DR. JULIO J LANDAETA
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Credential | PSYD
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Telephone | 305-609-0024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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