MEDICARE: JULIE DUDASH R.N.

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	163WC1600X	Continuing Education/Staff Development Registered Nurse	RN1243462	FL

General Provider Information

NPI Number	:	1912132309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE DUDASH R.N.

Provider Business Mailing Address
First Line	:	4010 WOODACRE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1223
Country	:	US
Telephone Number	:	813-416-0315
Fax Number	:

Provider Business Practice Location Address
First Line	:	4010 WOODACRE LN
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1223
Country	:	US
Telephone Number	:	813-416-0315
Fax Number	:

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

Provider Enumeration Date	:	05/28/2009
Last Update Date	:	05/28/2009

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