Provider Demographics
NPI:1275756843
Name:UMBERGER, JULIE MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:UMBERGER
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 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7539
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:813-355-5101
Practice Address - Street 1:9270 BAY PLAZA BLVD
Practice Address - Street 2:#620
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4499
Practice Address - Country:US
Practice Address - Phone:813-627-3222
Practice Address - Fax:813-740-0266
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL2141942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY6007ZMedicare ID - Type Unspecified
FLS35299Medicare UPIN