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General NPI Number Information
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NPI Number | 1528128915
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Entity Type | Individual
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Provider Name | JULIA ANNE TATUM HUNTER M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 1102 FLORIDA A1A NORTH DR. OZDEMIR OFFICE ST 104
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City | PONTE VEDRA
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State | FL
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Zip | 32082
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Country | US
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Telephone | 310-247-8744
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Fax | 310-247-0181
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Provider Business Mailing Address
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Address Line | 1102 A1A N STE 104
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City | PONTE VEDRA
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State | FL
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Zip | 32082-4098
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Country | US
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Telephone | 310-247-8744
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Fax | 310-247-0181
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | G69549
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G69549
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | ME148252
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License Number State | CA
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