Provider Demographics
NPI:1376510909
Name:FLICK, JULIE LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LYNN
Last Name:FLICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 COLLEGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-8525
Mailing Address - Country:US
Mailing Address - Phone:904-213-2700
Mailing Address - Fax:352-384-8032
Practice Address - Street 1:400 COLLEGE DR STE 200
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8525
Practice Address - Country:US
Practice Address - Phone:904-213-2700
Practice Address - Fax:352-384-8032
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL281285100Medicaid
FL281285100Medicaid