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NPI Code Detail

MEDICARE: JULIE KIET HANSON PA-C

MEDICARE: JULIE KIET HANSON PA-C
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
1363A00000XPhysician AssistantPA9105034FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073743100
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE KIET HANSON PA-C
Provider Business Mailing Address
First Line : 5365 W ATLANTIC AVE STE 504
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33484-8194
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1693 LEE RD
Second Line :
City : WINTER PARK
State : FL
Zip : 32789-2260
Country : US
Telephone Number : 407-622-5766
Fax Number : 407-622-5767
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2009
Last Update Date : 05/04/2012

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Directions to “ JULIE KIET HANSON PA-C” Practice Location

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