Provider Demographics
NPI:1205189586
Name:OLIVEIRA, JULIANA MARINI DE SOUZA (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:MARINI DE SOUZA
Last Name:OLIVEIRA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:MARINI DE
Other - Last Name:SOUZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3599 UNIVERSITY BLVD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4252
Mailing Address - Country:US
Mailing Address - Phone:904-345-7324
Mailing Address - Fax:
Practice Address - Street 1:801 WOODBURY RD STE 103
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4514
Practice Address - Country:US
Practice Address - Phone:407-373-6082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27782225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist