MEDICARE: JULIE VILLORIA

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	224Z00000X	Occupational Therapy Assistant	OTA 9824	FL
2	225700000X	Massage Therapist	MA25967	FL

General Provider Information

NPI Number	:	1689982563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE VILLORIA

Provider Business Mailing Address
First Line	:	PO BOX 2336
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34991-7336
Country	:	US
Telephone Number	:	772-224-4472
Fax Number	:

Provider Business Practice Location Address
First Line	:	3741 SW COQUINA COVE WAY
Second Line	:	#202
City	:	PALM CITY
State	:	FL
Zip	:	34990-8173
Country	:	US
Telephone Number	:	772-224-4472
Fax Number	:

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

Provider Enumeration Date	:	09/14/2010
Last Update Date	:	09/14/2010

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Directions to “ JULIE VILLORIA ” Practice Location

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