Provider Demographics
NPI:1316341753
Name:BUENDIA, JULIANA (PA-C)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:BUENDIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:STE 830
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4556
Mailing Address - Country:US
Mailing Address - Phone:305-532-0065
Mailing Address - Fax:
Practice Address - Street 1:1860 TOWN CENTER DR STE 300
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5900
Practice Address - Country:US
Practice Address - Phone:703-435-6604
Practice Address - Fax:703-662-4506
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9109466363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical