=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922215755
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE ELAINE HARPER LDO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2007
-----------------------------------------------------
Last Update Date | 07/09/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 461 S INDIANA AVE
-----------------------------------------------------
City | ENGLEWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34223-3701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-475-7784
-----------------------------------------------------
Fax | 941-475-7891
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8877 CALUMET BLVD
-----------------------------------------------------
City | PT CHARLOTTE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33981-3357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-475-7784
-----------------------------------------------------
Fax | 941-475-7891
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 156FX1800X
-----------------------------------------------------
Taxonomy Name | Optician
-----------------------------------------------------
License Number | 4172
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------