Provider Demographics
NPI:1699427229
Name:ENCISO TORPOCO, JULIO CESAR JR
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:ENCISO TORPOCO
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JULIO
Other - Middle Name:
Other - Last Name:ENCISO TORPOCO
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:JULIO ENCISO
Mailing Address - Street 1:1520 E 72ND ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3204
Mailing Address - Country:US
Mailing Address - Phone:317-529-3061
Mailing Address - Fax:
Practice Address - Street 1:1520 E 72ND ST UNIT B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3204
Practice Address - Country:US
Practice Address - Phone:317-529-3061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5310254884Medicaid