Provider Demographics
NPI:1588395909
Name:DUDKIEWICZ, JULIA (PA-C)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:DUDKIEWICZ
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1306 CONCOURSE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1503 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4733
Practice Address - Country:US
Practice Address - Phone:813-514-4688
Practice Address - Fax:813-341-3288
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2023-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9116111363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant