Provider Demographics
NPI:1487688503
Name:MENENDEZ, JULIO FAUSTINO (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIO
Middle Name:FAUSTINO
Last Name:MENENDEZ
Suffix:
Gender:M
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:PO BOX 3522
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34611
Mailing Address - Country:US
Mailing Address - Phone:352-666-8089
Mailing Address - Fax:352-666-6645
Practice Address - Street 1:11120 LIBBY RD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2454
Practice Address - Country:US
Practice Address - Phone:352-666-8089
Practice Address - Fax:352-666-6645
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79532208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG61447Medicare UPIN