Provider Demographics
NPI:1033799036
Name:MALONI, JULIE (MOTR/L)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MALONI
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 BERN CREEK LOOP
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8607
Mailing Address - Country:US
Mailing Address - Phone:941-223-0751
Mailing Address - Fax:
Practice Address - Street 1:157 S HAVANA RD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-3104
Practice Address - Country:US
Practice Address - Phone:941-493-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10480225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist