Provider Demographics
NPI:1588090617
Name:LAUDERDALE-GARZIA, JULIE NAN (MS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:NAN
Last Name:LAUDERDALE-GARZIA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 S SHORE DR S
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:FL
Mailing Address - Zip Code:33707-4621
Mailing Address - Country:US
Mailing Address - Phone:727-544-3038
Mailing Address - Fax:
Practice Address - Street 1:6901 S SHORE DR S
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-4621
Practice Address - Country:US
Practice Address - Phone:727-544-3038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health