Provider Demographics
NPI:1346534013
Name:SMITH BAZAN, JULIE ARLETTE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ARLETTE
Last Name:SMITH BAZAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12916 SW 132ND CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5819
Mailing Address - Country:US
Mailing Address - Phone:305-235-1072
Mailing Address - Fax:
Practice Address - Street 1:12916 SW 132ND CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5819
Practice Address - Country:US
Practice Address - Phone:305-235-1072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS22736183500000X
TX29105183500000X
CA40086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist