Provider Demographics
NPI:1215371265
Name:CORTESE, JULIE L (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:CORTESE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1590 S SR 15A
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-7817
Mailing Address - Country:US
Mailing Address - Phone:386-774-0016
Mailing Address - Fax:386-774-0606
Practice Address - Street 1:1590 S SR 15A
Practice Address - Street 2:SUITE 100
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-7817
Practice Address - Country:US
Practice Address - Phone:386-774-0016
Practice Address - Fax:386-774-0606
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9253663363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner