Provider Demographics
NPI:1437827151
Name:JULIEN, KATHERINA (PA-C)
Entity Type:Individual
Prefix:
First Name:KATHERINA
Middle Name:
Last Name:JULIEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 HARLANO ST
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-7164
Mailing Address - Country:US
Mailing Address - Phone:786-853-9562
Mailing Address - Fax:
Practice Address - Street 1:1801 NW 9TH AVE FL 5
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1125
Practice Address - Country:US
Practice Address - Phone:305-355-5831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9114824OtherFL LICENSE