Provider Demographics
NPI:1528746518
Name:EUSEBIO, JULIA VICTORIA
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:VICTORIA
Last Name:EUSEBIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2078 SHANNON LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-3648
Mailing Address - Country:US
Mailing Address - Phone:407-301-3517
Mailing Address - Fax:
Practice Address - Street 1:901 N LAKE DESTINY RD STE 400
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4891
Practice Address - Country:US
Practice Address - Phone:407-663-8248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL217131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical