Provider Demographics
NPI:1396884433
Name:JULIAO, CYNTHIA J (MS, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:J
Last Name:JULIAO
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 LARCHMONT DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4624
Mailing Address - Country:US
Mailing Address - Phone:941-460-8804
Mailing Address - Fax:
Practice Address - Street 1:1108 LARCHMONT DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223
Practice Address - Country:US
Practice Address - Phone:941-460-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY997231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL600254400Medicaid