MEDICARE: JULI G JEFFREY M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME107972	FL

General Provider Information

NPI Number	:	1750629044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULI G JEFFREY M.D.

Provider Business Mailing Address
First Line	:	3001 W. DR. MARTIN LUTHER KING JR. BLVD
Second Line	:	ST. JOSEPH'S HOSPITAL, DEPARTMENT OF PATHOLOGY
City	:	TAMPA
State	:	FL
Zip	:	33607
Country	:	US
Telephone Number	:	813-870-4206
Fax Number	:

Provider Business Practice Location Address
First Line	:	3001 W DR MARTIN LUTHER KING JR BLVD
Second Line	:	ST. JOSEPH'S HOSPITAL, DEPARTMENT OF PATHOLOGY
City	:	TAMPA
State	:	FL
Zip	:	33607-6307
Country	:	US
Telephone Number	:	813-870-4206
Fax Number	:

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

Provider Enumeration Date	:	01/22/2013
Last Update Date	:	01/22/2013

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