Provider Demographics
NPI:1215433024
Name:DELUCA, JULIANNA KAYE
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:KAYE
Last Name:DELUCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 SW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-6707
Mailing Address - Country:US
Mailing Address - Phone:561-929-2309
Mailing Address - Fax:
Practice Address - Street 1:146 RECREATION BLDG
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-5700
Practice Address - Country:US
Practice Address - Phone:561-929-2309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program