Provider Demographics
NPI:1164802245
Name:GLUKHOVSKAYA, JULIA (AP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GLUKHOVSKAYA
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-5564
Mailing Address - Country:US
Mailing Address - Phone:954-237-1358
Mailing Address - Fax:
Practice Address - Street 1:2110 N OCEAN BLVD APT 1401
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-1952
Practice Address - Country:US
Practice Address - Phone:954-663-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3566171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist