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General NPI Number Information
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NPI Number | 1386918217
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Entity Type | Individual
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Provider Name | JULINA TILLUS DORVAL ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/23/2012
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 9999 NE 2ND AVE STE 214
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City | MIAMI SHORES
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State | FL
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Zip | 33138-2345
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Country | US
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Telephone | 305-756-9392
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Fax | 305-756-9392
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Provider Business Mailing Address
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Address Line | 5260 SW 131ST TER
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City | MIRAMAR
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State | FL
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Zip | 33027-5415
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Country | US
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Telephone | 305-627-3828
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Fax | 305-756-9392
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP3078052
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License Number State | FL
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