MEDICARE: JULIA BENNETT APRN

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	363L00000X	Nurse Practitioner	11015294	FL

General Provider Information

NPI Number	:	1700511151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA BENNETT APRN

Provider Business Mailing Address
First Line	:	1317 EDGEWATER DR STE 4223
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6350
Country	:	US
Telephone Number	:	954-914-8474
Fax Number	:	407-887-1490

Provider Business Practice Location Address
First Line	:	1317 EDGEWATER DR STE 4223
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-6350
Country	:	US
Telephone Number	:	954-914-8474
Fax Number	:	407-887-1490

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

Provider Enumeration Date	:	07/20/2022
Last Update Date	:	07/01/2025

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