Provider Demographics
NPI:1487645883
Name:VASTA, JULIA ANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:VASTA
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 1:3633 LITTLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1815
Mailing Address - Country:US
Mailing Address - Phone:727-375-2222
Mailing Address - Fax:866-244-2335
Practice Address - Street 1:3633 LITTLE RD STE 101
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1818
Practice Address - Country:US
Practice Address - Phone:727-375-2222
Practice Address - Fax:866-244-2335
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3052242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
U0407ZMedicare ID - Type Unspecified
FLP84810Medicare UPIN