MEDICARE: MRS. JULIE REESE RONHAAR ARNP

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	363LP0200X	Pediatric Nurse Practitioner	ARNP9236510	FL

General Provider Information

NPI Number	:	1902232481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE REESE RONHAAR ARNP

Provider Business Mailing Address
First Line	:	270 N SYKES CREEK PKWY
Second Line	:	SUITE 108
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-3492
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	270 N SYKES CREEK PKWY
Second Line	:	SUITE 108
City	:	MERRITT ISLAND
State	:	FL
Zip	:	32953-3492
Country	:	US
Telephone Number	:	321-452-1061
Fax Number	:

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

Provider Enumeration Date	:	09/17/2013
Last Update Date	:	09/17/2013

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