Provider Demographics
NPI:1437262953
Name:BECKWITT, JULIE-ANN (OD)
Entity Type:Individual
Prefix:
First Name:JULIE-ANN
Middle Name:
Last Name:BECKWITT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 SW 93RD COURT RD STE 15
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34481-5188
Mailing Address - Country:US
Mailing Address - Phone:352-291-2000
Mailing Address - Fax:
Practice Address - Street 1:11100 SW 93RD COURT RD STE 15
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-5188
Practice Address - Country:US
Practice Address - Phone:352-291-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1814152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL621342100Medicaid
FLT84183Medicare UPIN