MEDICARE: MR. JULIJE VUCEMILOVIC MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME77704	FL

General Provider Information

NPI Number	:	1053318329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JULIJE VUCEMILOVIC MD

Provider Business Mailing Address
First Line	:	PO BOX 2832
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33806-2832
Country	:	US
Telephone Number	:	727-384-4060
Fax Number	:

Provider Business Practice Location Address
First Line	:	6560 9TH AVE N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33710-6216
Country	:	US
Telephone Number	:	727-384-4060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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