Provider Demographics
NPI:1457554289
Name:STUBRUD FLOYD, JULIE DIANE (DC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:DIANE
Last Name:STUBRUD FLOYD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:DIANE
Other - Last Name:STUBRUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6405 SW 38TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6540
Mailing Address - Country:US
Mailing Address - Phone:352-390-6133
Mailing Address - Fax:352-390-6961
Practice Address - Street 1:6405 SW 38TH ST STE 203
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6540
Practice Address - Country:US
Practice Address - Phone:352-390-6133
Practice Address - Fax:352-390-6961
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64206OtherBCBS
FL382203600Medicaid
FL9111145OtherAETNA
FL382203600Medicaid
FL9111145OtherAETNA