MEDICARE: JULISA G BURNS

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

General Provider Information

NPI Number	:	1760948541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULISA G BURNS

Provider Business Mailing Address
First Line	:	9234 LAKE FISCHER BLVD
Second Line	:
City	:	GOTHA
State	:	FL
Zip	:	34734-5203
Country	:	US
Telephone Number	:	407-590-6465
Fax Number	:

Provider Business Practice Location Address
First Line	:	9234 LAKE FISCHER BLVD
Second Line	:
City	:	GOTHA
State	:	FL
Zip	:	34734-5203
Country	:	US
Telephone Number	:	407-590-6465
Fax Number	:

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

Provider Enumeration Date	:	02/15/2019
Last Update Date	:	02/15/2019

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Directions to “ JULISA G BURNS ” Practice Location

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