Provider Demographics
NPI:1326011925
Name:BAUER, JULIE A (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:BAUER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3113 LAWTON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3519
Mailing Address - Country:US
Mailing Address - Phone:407-894-3241
Mailing Address - Fax:407-896-9863
Practice Address - Street 1:3113 LAWTON RD STE 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3519
Practice Address - Country:US
Practice Address - Phone:407-894-3241
Practice Address - Fax:407-896-9863
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067923207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31746AMedicare ID - Type Unspecified
G26643Medicare UPIN