Provider Demographics
NPI:1427294412
Name:HENRY R. JULME MD PA INC.
Entity type:Organization
Organization Name:HENRY R. JULME MD PA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELES
Authorized Official - Middle Name:C
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-538-2160
Mailing Address - Street 1:P.O. BOX 398566
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33239
Mailing Address - Country:US
Mailing Address - Phone:305-538-2160
Mailing Address - Fax:305-538-2120
Practice Address - Street 1:333 ARTHUR GODFREY RD
Practice Address - Street 2:SUITE # 702
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3641
Practice Address - Country:US
Practice Address - Phone:305-538-2160
Practice Address - Fax:305-538-2120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-23
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0064951207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL23593Medicare PIN
FLF70214Medicare UPIN