Provider Demographics
NPI:1427507664
Name:KIM, JULIE MIN JEONG (AP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MIN JEONG
Last Name:KIM
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 NE 25TH ST APT 808
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4757
Mailing Address - Country:US
Mailing Address - Phone:305-803-1050
Mailing Address - Fax:
Practice Address - Street 1:9999 NE 2ND AVE STE 313
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2346
Practice Address - Country:US
Practice Address - Phone:305-771-2115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3769171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist