MEDICARE: JULIANA FONTENELE BIZERRIL-WILLIAMS

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	363AM0700X	Medical Physician Assistant	016809-1	NY

General Provider Information

NPI Number	:	1710310313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA FONTENELE BIZERRIL-WILLIAMS

Provider Business Mailing Address
First Line	:	267A W 231ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3903
Country	:	US
Telephone Number	:	718-432-8282
Fax Number	:

Provider Business Practice Location Address
First Line	:	267A W 231ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3903
Country	:	US
Telephone Number	:	718-432-8282
Fax Number	:

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

Provider Enumeration Date	:	08/19/2013
Last Update Date	:	05/18/2025

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