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General NPI Number Information
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NPI Number | 1730142647
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Entity Type | Individual
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Provider Name | JULIET MARIE DE CAMPOS M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 03/16/2022
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Provider Practice Location Address
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Address Line | 4900 BAYOU BLVD STE 107
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City | PENSACOLA
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State | FL
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Zip | 32503-2543
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Country | US
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Telephone | 850-741-2814
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Fax | 850-741-2948
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Provider Business Mailing Address
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Address Line | PO BOX 30010
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City | PENSACOLA
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State | FL
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Zip | 32503-1010
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Country | US
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Telephone | 850-479-3320
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Fax | 850-479-8789
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME69848
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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